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https://www.readbyqxmd.com/read/28108211/user-centered-design-improves-the-usability-of-drug-drug-interaction-alerts-experimental-comparison-of-interfaces
#1
Daniel R Luna, Daniel A Rizzato Lede, Carlos M Otero, Marcelo R Risk, Fernán González Bernaldo de Quirós
Clinical Decision Support Systems can alert health professionals about drug interactions when they prescribe medications. The Hospital Italiano de Buenos Aires in Argentina developed an electronic health record with drug-drug interaction alerts, using traditional software engineering techniques and requirements. Despite enhancing the drug-drug interaction knowledge database, the alert override rate of this system was very high. We redesigned the alert system using user-centered design (UCD) and participatory design techniques to enhance the drug-drug interaction alert interface...
January 17, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28104826/screening-for-medication-errors-using-an-outlier-detection-system
#2
Gordon D Schiff, Lynn A Volk, Mayya Volodarskaya, Deborah H Williams, Lake Walsh, Sara G Myers, David W Bates, Ronen Rozenblum
OBJECTIVE: The study objective was to evaluate the accuracy, validity, and clinical usefulness of medication error alerts generated by an alerting system using outlier detection screening. MATERIALS AND METHODS: Five years of clinical data were extracted from an electronic health record system for 747 985 patients who had at least one visit during 2012-2013 at practices affiliated with 2 academic medical centers. Data were screened using the system to detect outliers suggestive of potential medication errors...
January 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28090397/insights-about-fall-prevention-of-older-adults-in-the-state-of-hawai-i
#3
Yuka Yamazaki, Cullen T Hayashida, Valerie Yontz
The senior population in Hawai'i is growing at a dramatic pace. In the older population, falls and fall-related injuries are leading causes of morbidity and mortality. Moreover, the health care costs for falls are very high. The State of Hawai'i has taken measures to prevent falls through the promotion of medication reviews, vision checks, home assessments, and exercise. However, current published examinations of fall preventive measures have been insufficient, and more research is needed to confirm risk factors, effectiveness of preventive measures, and to explore future objectives...
January 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28077345/tips-and-traps-lessons-from-codesigning-a-clinician-e-monitoring-tool-for-computerized-cognitive-behavioral-therapy
#4
Frederick Sundram, Susan J Hawken, Karolina Stasiak, Mathijs Fg Lucassen, Theresa Fleming, Matthew Shepherd, Andrea Greenwood, Raechel Osborne, Sally N Merry
BACKGROUND: Computerized cognitive behavioral therapy (cCBT) is an acceptable and promising treatment modality for adolescents with mild-to-moderate depression. Many cCBT programs are standalone packages with no way for clinicians to monitor progress or outcomes. We sought to develop an electronic monitoring (e-monitoring) tool in consultation with clinicians and adolescents to allow clinicians to monitor mood, risk, and treatment adherence of adolescents completing a cCBT program called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts)...
January 11, 2017: JMIR Mental Health
https://www.readbyqxmd.com/read/28063462/going-digital-a-narrative-overview-of-the-clinical-and-organisational-impacts-of-ehealth-technologies-in-hospital-practice
#5
Justin Keasberry, Ian A Scott, Clair Sullivan, Andrew Staib, Richard Ashby
Objective The aim of the present study was to determine the effects of hospital-based eHealth technologies on quality, safety and efficiency of care and clinical outcomes.Methods Systematic reviews and reviews of systematic reviews of eHealth technologies published in PubMed/Medline/Cochrane Library between January 2010 and October 2015 were evaluated. Reviews of implementation issues, non-hospital settings or remote care or patient-focused technologies were excluded from analysis. Methodological quality was assessed using a validated appraisal tool...
January 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28047723/su-f-t-559-high-resolution-scintillating-fiber-array-for-in-vivo-real-time-srs-and-sbrt-patient-qa
#6
T Knewtson, S Pokhrel, S Loyalka, E Izaguirre
PURPOSE: A high-resolution scintillating fiber detector was built for in-vivo real-time patient specific quality assurance (QA). The detector is designed for stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS) to monitor treatment delivery and detect real-time deviations from planned dose to increase patient safety and treatment accuracy. METHODS: The detector consists of two high-density scintillating fiber arrays layered to form an X-Y grid which can be attached to the accessory tray of a medical linac for SBRT and cone SRS treatment QA...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28042124/improvement-in-herpes-zoster-vaccination-in-patients-with-rheumatoid-arthritis-a-quality-improvement-project
#7
Heena Sheth, Larry Moreland, Hilary Peterson, Rohit Aggarwal
OBJECTIVE: To improve herpes zoster (HZ) vaccination rates in high-risk patients with rheumatoid arthritis (RA) being treated with immunosuppressive therapy. METHODS: This quality improvement project was based on the pre- and post-intervention design. The project targeted all patients with RA over the age of 60 years while being treated with immunosuppressive therapy (not with biologics) seen in 13 rheumatology outpatient clinics. The study period was from July 2012 to June 2013 for the pre-intervention and February 2014 to January 2015 for the post-intervention phase...
January 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28008599/screening-tool-of-older-person-s-prescriptions-screening-tools-to-alert-doctors-to-right-treatment-medication-criteria-modified-for-u-s-nursing-home-setting
#8
Dmitry Khodyakov, Aileen Ochoa, Brianne L Olivieri-Mui, Carla Bouwmeester, Barbara J Zarowitz, Meenakshi Patel, Diana Ching, Becky Briesacher
OBJECTIVES: To develop a set of prescribing indicators measurable with available data from electronic nursing home (NH) databases by adapting the European-based 2014 Screening Tool of Older Person's Prescriptions (STOPP) and Screening Tools to Alert Doctors to Right Treatment (START) criteria of potentially inappropriate and underused medications for the U.S. SETTING: HASH(0x53b3b20) DESIGN: A two-stage expert panel process. In the first stage, the investigator team reviewed 114 criteria for compatibility and measurability...
December 23, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27999065/electronic-prescribing-system-design-priorities-for-antimicrobial-stewardship-a-cross-sectional-survey-of-142-uk-infection-specialists
#9
Kieran S Hand, Debbie Cumming, Susan Hopkins, Sean Ewings, Andy Fox, Sandya Theminimulle, Robert J Porter, Natalie Parker, Joanne Munns, Adel Sheikh, Taryn Keyser, Richard Puleston
BACKGROUND: The implementation of electronic prescribing and medication administration (EPMA) systems is a priority for hospitals and a potential component of antimicrobial stewardship (AMS). OBJECTIVES: To identify software features within EPMA systems that could potentially facilitate AMS and to survey practising UK infection specialist healthcare professionals in order to assign priority to these software features. METHODS: A questionnaire was developed using nominal group technique and transmitted via email links through professional networks...
December 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27942948/potentially-inappropriate-prescribing-in-a-population-of-frail-elderly-people
#10
Isabelle Récoché, Cécile Lebaudy, Charlène Cool, Sandrine Sourdet, Antoine Piau, Maryse Lapeyre-Mestre, Bruno Vellas, Philippe Cestac
Background Frailty is a clinical syndrome highly predictive of functional decline after a stress or a medical event, such as adverse drug events. Objective To describe the prevalence of potentially inappropriate prescribing in a population of frail elderly patients. Setting Geriatric day hospital for assessment of frailty and prevention of disability, Toulouse, France. Method A cross-sectional study performed from January to April 2014. Two pharmacists retrospectively analyzed the prescriptions of elderly patients who were sent to the day hospital to assess their frailty and to be given a personalized plan of care and prevention...
December 10, 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27920036/clinical-relevance-of-pharmacist-intervention-in-an-emergency-department
#11
Maria Antonia Pérez-Moreno, Juan Manuel Rodríguez-Camacho, Beatriz Calderón-Hernanz, Bernardino Comas-Díaz, Jordi Tarradas-Torras
OBJECTIVES: To evaluate the clinical relevance of pharmacist intervention on patient care in emergencies, to determine the severity of detected errors. Second, to analyse the most frequent types of interventions and type of drugs involved and to evaluate the clinical pharmacist's activity. METHODS: A 6-month observational prospective study of pharmacist intervention in the Emergency Department (ED) at a 400-bed hospital in Spain was performed to record interventions carried out by the clinical pharmacists...
December 5, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27919826/should-blood-pressure-goal-be-individualized-in-hypertensive-patients
#12
REVIEW
Alexandra Yannoutsos, Rania Kheder-Elfekih, Jean-Michel Halimi, Michel E Safar, Jacques Blacher
The aim of the present review is to consider the clinical relevance of individualized blood pressure (BP) goal under treatment in hypertensive patients according to their age, comorbidities or established cardiovascular (CV) disease. Evidence from large-scale randomized trials to support a lower BP goal, as initially recommended by guidelines in high-risk hypertensive patients, were lacking. Recently, the randomized intervention SPRINT trial studied two treatment targets for systolic BP (120mm Hg versus 140mm Hg in the intensive and standard treatment group, respectively) among high-risk hypertensive patients, without diabetes and without a history of prior stroke...
December 2, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27919368/clinical-reasoning-in-the-context-of-active-decision-support-during-medication-prescribing
#13
Jan Horsky, Jos Aarts, Leonie Verheul, Diane L Seger, Heleen van der Sijs, David W Bates
OBJECTIVE: Describe and analyze reasoning patterns of clinicians responding to drug-drug interaction alerts in order to understand the role of patient-specific information in the decision-making process about the risks and benefits of medication therapy. Insights could be used to inform the design of decision-support interventions. METHODS: Thirty-two clinicians working with five EHRs in two countries completed sets of six medication orders each and responded to high- and low-severity drug-drug interaction alerts while verbalizing their thoughts in a standard think-aloud protocol...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27904631/the-effect-of-clinical-supervision-model-on-high-alert-medication-safety-in-intensive-care-units-nurses
#14
Asghar Khalifehzadeh Esfahani, Fatemeh Ramezany Varzaneh, Tahereh Changiz
BACKGROUND: Medication errors and adverse drug events of high alert medication are one of the major problems in therapeutic system. The purpose of the present study was to investigate ύthe effect of clinical supervision model on high alert medication safety in intensive care units nurses. MATERIALS AND METHODS: This was a quasi-experimental study conducted on 32 nurses of intensive care units. The researcher observed the administration of high alert drugs including heparin, warfarin, norepinephrine, dobutamine, and dopamine by nurses and recorded the scores of the work in preventing medication errors, the work in preventing adverse drug events, and medication safety...
September 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/27879085/potential-drug-drug-interactions-and-adverse-drug-reactions-in-dermatological-inpatients
#15
Lukas Koch, Birger Kränke, Werner Aberer
OBJECTIVES: To present information on the frequency of drug-drug interactions and adverse drug reactions, and to provide assistance on how to minimize these major problems in the pharmacological treatment of dermatological inpatients. PATIENTS AND METHODS: The medications given to 1,099 dermatological inpatients were retrospectively analyzed for drug-drug interactions and adverse drug reactions using web-based drug interaction software (Diagnosia(®) Check). RESULTS: We report an overall frequency of relevant drug-drug interactions of 51...
November 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/27869877/-computerized-decision-support-systems-ebm-at-the-bedside
#16
Matteo Capobussi, Rita Banzi, Lorenzo Moja, Stefanos Bonovas, Marien González-Lorenzo, Elisa Giulia Liberati, Hernan Polo Friz, Oriana Nanni, Massimo Mangia, Francesca Ruggiero
INTRODUCTION: One of the aims of Evidence-Based Medicine is to improve quality and appropriateness of care by the expedition of the knowledge transfer process. Computerized Decision Support Systems (CDSSs) are computer programs that provide alerts to the prescribing doctor directly at the moment of medical examination. In fact, alerts are integrated within the single patient electronic health record. CDSS based on the best available and updated evidence and guidelines may be an efficient tool to facilitate the transfer of the latest results from clinical research directly at the bedside, thus supporting decision-making...
November 2016: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/27864167/testing-the-feasibility-of-remote-patient-monitoring-in-prenatal-care-using-a-mobile-app-and-connected-devices-a-prospective-observational-trial
#17
Kathryn I Marko, Jill M Krapf, Andrew C Meltzer, Julia Oh, Nihar Ganju, Anjali G Martinez, Sheetal G Sheth, Nancy D Gaba
BACKGROUND: Excessive weight gain and elevated blood pressure are significant risk factors for adverse pregnancy outcomes such as gestational diabetes, premature birth, and preeclampsia. More effective strategies to facilitate adherence to gestational weight gain goals and monitor blood pressure may have a positive health benefit for pregnant women and their babies. The impact of utilizing a remote patient monitoring system to monitor blood pressure and weight gain as a component of prenatal care has not been previously assessed...
November 18, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27858867/child-protection-medical-service-demonstration-centers-in-approaching-child-abuse-and-neglect-in-taiwan
#18
Yu-Ching Chang, Jing-Long Huang, Shao-Hsuan Hsia, Kuang-Lin Lin, En-Pei Lee, I-Jun Chou, Yi-Chen Hsin, Fu-Song Lo, Chang-Teng Wu, Cheng-Hsun Chiu, Han-Ping Wu
Child abuse includes all forms of physical and emotional ill treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child's health, development, or dignity. In Taiwan, the Child Protection Medical Service Demonstration Center (CPMSDC) was established to protect children from abuse and neglect. We further analyzed and compared the trends and clinical characteristics of cases reported by CPMSDC to evaluate the function of CPMSDC in approaching child abuse and neglect in Taiwan...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27853396/development-of-training-related-health-care-software-by-a-team-of-clinical-educators-their-experience-from-conception-to-piloting
#19
Derfel Ap Dafydd, Ruth Williamson, Philip Blunt, Dominic M Blunt
The difficulties of producing useful, bespoke, and affordable information technology systems for large health care organizations are well publicized, following several high-profile endeavors in the UK. This article describes the experience of a small group of clinical radiologists and their collaborators in producing an information technology system - from conception to piloting. This system, called Trainee Tracker, enables automated target date recalculation of trainee milestones, depending on their work patterns and other individual circumstances...
2016: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/27826189/behavioral-emergency-in-the-elderly-a-descriptive-study-of-patients-referred-to-an-aggression-response-team-in-an-acute-hospital
#20
Daniel Simpkins, Carmelle Peisah, Irene Boyatzis
AIM: The management of severely agitated elderly patients is not easy, and limited guidelines are available to assist practitioners. At a Sydney hospital, an Aggression Response Team (ART) comprising clinical and security staff can be alerted when a staff member has safety concerns. Our aims were to describe the patient population referred for ART calls, reasons for and interventions during ART calls, and complications following them. METHODS: Patients 65 years and older referred for ART calls in the emergency department or wards during 2014 were identified using the Incident Information Management System database and medical records were reviewed...
2016: Clinical Interventions in Aging
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