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https://www.readbyqxmd.com/read/29333660/interventions-to-increase-attendance-for-diabetic-retinopathy-screening
#1
REVIEW
John G Lawrenson, Ella Graham-Rowe, Fabiana Lorencatto, Jennifer Burr, Catey Bunce, Jillian J Francis, Patricia Aluko, Stephen Rice, Luke Vale, Tunde Peto, Justin Presseau, Noah Ivers, Jeremy M Grimshaw
BACKGROUND: Despite evidence supporting the effectiveness of diabetic retinopathy screening (DRS) in reducing the risk of sight loss, attendance for screening is consistently below recommended levels. OBJECTIVES: The primary objective of the review was to assess the effectiveness of quality improvement (QI) interventions that seek to increase attendance for DRS in people with type 1 and type 2 diabetes.Secondary objectives were:To use validated taxonomies of QI intervention strategies and behaviour change techniques (BCTs) to code the description of interventions in the included studies and determine whether interventions that include particular QI strategies or component BCTs are more effective in increasing screening attendance;To explore heterogeneity in effect size within and between studies to identify potential explanatory factors for variability in effect size;To explore differential effects in subgroups to provide information on how equity of screening attendance could be improved;To critically appraise and summarise current evidence on the resource use, costs and cost effectiveness...
January 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29329162/reorganizing-care-with-the-implementation-of-electronic-medical-records-a-time-motion-study-in-the-picu
#2
Nadia Roumeliotis, Geneviève Parisien, Sylvie Charette, Elizabeth Arpin, Fabrice Brunet, Philippe Jouvet
OBJECTIVES: To assess caregivers' patient care time before and after the implementation of a reorganization of care plan with electronic medical records. DESIGN: A prospective, observational, time-motion study. SETTING: A level 3 PICU. PARTICIPANTS: Nurses and orderlies caring for intubated patients during an 8-hour work shift before (2008-2009) and after (2016) implementation of reorganization of care in 2013. INTERVENTIONS: The reorganization plan included improved telecommunication for healthcare workers, increased tasks delegated to orderlies, and an ICU-specific electronic medical record (Intellispace Critical Care and Anesthesia information system, Philips Healthcare)...
January 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29324559/nurse-experiences-of-medication-administration-to-people-with-swallowing-difficulties-living-in-aged-care-facilities-a-systematic-review-of-qualitative-evidence
#3
Aida Sefidani Forough, Simon Y M Wong, Esther T L Lau, Jose Manuel Serrano Santos, Greg J Kyle, Kathryn J Steadman, Julie A Y Cichero, Lisa M Nissen
OBJECTIVE: To identify nurses' experiences of administering oral medications to residents of aged care facilities (ACFs) with swallowing difficulties. INTRODUCTION: Administering medicines to older people with swallowing difficulties is a challenging task. Nurses frequently modify oral medications e.g. by crushing/splitting tablets or opening capsules, to facilitate the administration process. These practices are associated with an increased risk of medication administration errors...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29322489/measurement-in-pediatric-epilepsy-self-management-a-critical-review
#4
REVIEW
Gigi Smith, Avani C Modi, Erica K Johnson, Ross Shegog, Joan K Austin, Janelle L Wagner
Given the paucity of information available regarding self-management, the aims of this paper are to synthesize the literature on factors associated with and measures to assess self-management in pediatric epilepsy. INCLUSION CRITERIA: youth birth to 18 years with a seizure disorder or an epilepsy diagnosis and/or their caregivers, published 1985-2014 in English, and conducted in countries with a very high human development index. The review was conducted in 6 phases: (1) identification of bibliographical search criteria and databases; (2) abstract assessment; (3) full article review; (4) organization of final citations into categories; (5) identification of predictors, potential mediators/moderators, and outcomes associated with self-management factors and categorization of factors as influences, processes, or behaviors across individual, family, community, and health care domains; and (6) critique of self-management instrument studies...
January 11, 2018: Epilepsia
https://www.readbyqxmd.com/read/29316925/extending-coverage-to-informal-sector-populations-in-kenya-design-preferences-and-implications-for-financing-policy
#5
Vincent Okungu, Jane Chuma, Stephen Mulupi, Diane McIntyre
BACKGROUND: Universal health coverage (UHC) is important in terms of improving access to quality health care while protecting households from the risk of catastrophic health spending and impoverishment. However, progress to UHC has been hampered by the measures to increase mandatory prepaid funds especially in low- and middle-income countries where there are large populations in the informal sector. Important considerations in expanding coverage to the informal sector should include an exploration of the type of prepayment system that is acceptable to the informal sector and the features of such a design that would encourage prepayment for health care among this population group...
January 9, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29310496/survey-to-identify-depth-of-penetration-of-critical-incident-reporting-systems-in-austrian-healthcare-facilities
#6
Gerald Sendlhofer, Harald Eder, Karina Leitgeb, Roland Gorges, Heidelinde Jakse, Marianne Raiger, Silvia Türk, Walter Petschnig, Gudrun Pregartner, Lars-Peter Kamolz, Gernot Brunner
Incident reporting systems or so-called critical incident reporting systems (CIRS) were first recommended for use in health care more than 15 years ago. The uses of these CIRS are highly variable among countries, ranging from being used to report critical incidents, falls, or sentinel events resulting in death. In Austria, CIRS have only been introduced to the health care sector relatively recently. The goal of this work, therefore, was to determine whether and specifically how CIRS are used in Austria. A working group from the Austrian Society for Quality and Safety in Healthcare (ASQS) developed a survey on the topic of CIRS to collect information on penetration of CIRS in general and on how CIRS reports are used to increase patient safety...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29303209/point-of-care-gastrointestinal-and-urinary-tract-sonography-in-daily-evaluation-of-gastrointestinal-dysfunction-in-critically-ill-patients-guts-protocol
#7
Angel Augusto Perez-Calatayud, Raul Carrillo-Esper, Eduardo Daniel Anica-Malagon, Jesus Carlos Briones-Garduño, Emilio Arch-Tirado, Robert Wise, Manu L N G Malbrain
PURPOSE: There is currently a lack of universally accepted criteria for gastrointestinal (GI) failure or dysfunction in critical care. Also, the clinical assessment of intestinal function is notoriously difficult and thus often goes unrecognized, contributing to poor outcomes. A recent grading system has been proposed to define acute gastrointestinal injury (AGI) in conjunction with other organ function scores (e.g., SOFA). Ultrasonography has become widely accepted as a diagnostic tool for GI problems and pathology...
January 5, 2018: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29297401/improving-data-quality-across-3-sub-saharan-african-countries-using-the-consolidated-framework-for-implementation-research-cfir-results-from-the-african-health-initiative
#8
Sarah Gimbel, Moses Mwanza, Marie Paul Nisingizwe, Cathy Michel, Lisa Hirschhorn
BACKGROUND: High-quality data are critical to inform, monitor and manage health programs. Over the seven-year African Health Initiative of the Doris Duke Charitable Foundation, three of the five Population Health Implementation and Training (PHIT) partnership projects in Mozambique, Rwanda, and Zambia introduced strategies to improve the quality and evaluation of routinely-collected data at the primary health care level, and stimulate its use in evidence-based decision-making. Using the Consolidated Framework for Implementation Research (CFIR) as a guide, this paper: 1) describes and categorizes data quality assessment and improvement activities of the projects, and 2) identifies core intervention components and implementation strategy adaptations introduced to improve data quality in each setting...
December 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29297352/tackling-the-hard-problems-implementation-experience-and-lessons-learned-in-newborn-health-from-the-african-health-initiative
#9
Hema Magge, Roma Chilengi, Elizabeth F Jackson, Bradley H Wagenaar, Almamy Malick Kante
BACKGROUND: The Doris Duke Charitable Foundation's African Health Initiative supported the implementation of Population Health Implementation and Training (PHIT) Partnership health system strengthening interventions in designated areas of five countries: Ghana, Mozambique, Rwanda, Tanzania, and Zambia. All PHIT programs included health system strengthening interventions with child health outcomes from the outset, but all increasingly recognized the need to increase focus to improve health and outcomes in the first month of life...
December 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29297336/engaging-stakeholders-lessons-from-the-use-of-participatory-tools-for-improving-maternal-and-child-care-health-services
#10
Elizabeth Ekirapa-Kiracho, Upasona Ghosh, Rittika Brahmachari, Ligia Paina
BACKGROUND: Effective stakeholder engagement in research and implementation is important for improving the development and implementation of policies and programmes. A varied number of tools have been employed for stakeholder engagement. In this paper, we discuss two participatory methods for engaging with stakeholders - participatory social network analysis (PSNA) and participatory impact pathways analysis (PIPA). Based on our experience, we derive lessons about when and how to apply these tools...
December 28, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/29294854/disclosing-gender-based-violence-during-health-care-visits-a-patient-centered-approach
#11
Jessica R Williams, Rosa M Gonzalez-Guarda, Valerie Halstead, Jacob Martinez, Laly Joseph
The purpose of this study was to better understand victims' perspectives regarding decisions to disclose gender-based violence, namely, intimate partner violence (IPV) and human trafficking, to health care providers and what outcomes matter to them when discussing these issues with their provider. Twenty-five participants from racially/ethnically diverse backgrounds were recruited from a family justice center located in the southeastern United States. Two fifths had experienced human trafficking, and the remaining had experienced IPV...
July 1, 2017: Journal of Interpersonal Violence
https://www.readbyqxmd.com/read/29286945/an-interpretable-machine-learning-model-for-accurate-prediction-of-sepsis-in-the-icu
#12
Shamim Nemati, Andre Holder, Fereshteh Razmi, Matthew D Stanley, Gari D Clifford, Timothy G Buchman
OBJECTIVES: Sepsis is among the leading causes of morbidity, mortality, and cost overruns in critically ill patients. Early intervention with antibiotics improves survival in septic patients. However, no clinically validated system exists for real-time prediction of sepsis onset. We aimed to develop and validate an Artificial Intelligence Sepsis Expert algorithm for early prediction of sepsis. DESIGN: Observational cohort study. SETTING: Academic medical center from January 2013 to December 2015...
December 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29283893/out-of-system-care-and-recording-of-patient-characteristics-critical-for-comparative-effectiveness-research
#13
Kueiyu Joshua Lin, Robert J Glynn, Daniel E Singer, Shawn N Murphy, Joyce Lii, Sebastian Schneeweiss
BACKGROUND: It is unclear how out-of-system care or electronic health record (EHR) discontinuity (i.e., receiving care outside of an EHR system) may affect validity of comparative effectiveness research using these data. We aimed to compare the misclassification of key variables in patients with high vs. low EHR-continuity. METHODS: The study cohort comprised patients aged ≥65 identified in electronic health records from two US provider networks linked with Medicare insurance claims data from 2007-2014...
December 26, 2017: Epidemiology
https://www.readbyqxmd.com/read/29282109/simulated-patient-encounters-to-improve-adolescent-retention-in-hiv-care-in-kenya-study-protocol-of-a-stepped-wedge-randomized-controlled-trial
#14
Kate S Wilson, Cyrus Mugo, David Bukusi, Irene Inwani, Anjuli D Wagner, Helen Moraa, Tamara Owens, Joseph B Babigumira, Barbra A Richardson, Grace C John-Stewart, Jennifer A Slyker, Dalton C Wamalwa, Pamela K Kohler
BACKGROUND: Adolescent-friendly policies aim to tailor HIV services for adolescents and young adults aged 10-24 years (AYA) to promote health outcomes and improve retention in HIV care and treatment. However, few interventions focus on improving healthcare worker (HCW) competencies and skills for provision of high-quality adolescent care. Standardized patients (SPs) are trained actors who work with HCWs in mock clinical encounters to improve clinical assessment, communication, and empathy skills...
December 28, 2017: Trials
https://www.readbyqxmd.com/read/29281974/development-of-an-intervention-to-reduce-antibiotic-use-for-childhood-coughs-in-uk-primary-care-using-critical-synthesis-of-multi-method-research
#15
Patricia J Lucas, Jenny Ingram, Niamh M Redmond, Christie Cabral, Sophie L Turnbull, Alastair D Hay
BACKGROUND: Overuse of antibiotics contributes to the global threat of antimicrobial resistance. Antibiotic stewardship interventions address this threat by reducing the use of antibiotics in occasions or doses unlikely to be effective. We aimed to develop an evidence-based, theory-informed, intervention to reduce antibiotic prescriptions in primary care for childhood respiratory tract infections (RTI). This paper describes our methods for doing so. METHODS: Green and Krueter's Precede/Proceed logic model was used as a framework to integrate findings from a programme of research including 5 systematic reviews, 3 qualitative studies, and 1 cohort study...
December 28, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/29280903/framework-for-research-on-implementation-of-process-redesigns
#16
Mahima Ashok, Dorothy Hung, Lucia Rojas-Smith, Michael T Halpern, Michael Harrison
BACKGROUND: Complex system interventions benefit from close attention to factors affecting implementation and resultant outcomes. This article describes a framework for examining these factors in process redesign (PR) and for assessing PR outcomes. METHODS: Using literature scans and expert comment on draft frameworks based on the Consolidated Framework for Implementation Research, a team of researchers developed the PR framework for the Agency for Healthcare Research and Quality...
January 2018: Quality Management in Health Care
https://www.readbyqxmd.com/read/29280902/assessing-the-organizational-characteristics-influencing-quality-improvement-implementation-in-saudi-hospitals
#17
Mohammad Shamsuddin Alaraki
BACKGROUND: The health care system in Saudi Arabia has serious problems with quality and safety that can be reduced through systematic quality improvement (QI) activities. Despite the use of different QI models to improve health care in Saudi hospitals during the last 2 decades, consistent improvements have not yet been achieved and the results are still far below expectations. This may reflect a problem in introducing and implementing the QI models in the local contexts. The objective of this study is to assess the extent of QI implementation in Saudi hospitals and to identify the organizational characteristics that make Saudi hospitals particularly challenging for QI...
January 2018: Quality Management in Health Care
https://www.readbyqxmd.com/read/29280167/from-applied-ethics-to-empirical-ethics-to-contextual-ethics
#18
Barry Hoffmaster
Bioethics became applied ethics when it was assimilated to moral philosophy. Because deduction is the rationality of moral philosophy, subsuming facts under moral principles to deduce conclusions about what ought to be done became the prescribed reasoning of bioethics, and bioethics became a theory comprised of moral principles. Bioethicists now realize that applied ethics is too abstract and spare to apprehend the specificity, particularity, complexity and contingency of real moral issues. Empirical ethics and contextual ethics are needed to incorporate these features into morality, not just bioethics...
December 27, 2017: Bioethics
https://www.readbyqxmd.com/read/29277162/a-european-late-starter-lessons-from-the-history-of-reform-in-irish-health-care
#19
Maev-Ann Wren, Sheelah Connolly
The Irish health care system is unusual within Europe in not providing universal, equitable access to either primary or acute hospital care. The majority of the population pays out-of-pocket fees to access primary health care. Due to long waits for public hospital care, many purchase private health insurance, which facilitates faster access to public and private hospital services. The system has been the subject of much criticism and repeated reform attempts. Proposals in 2011 to develop a universal health care system, funded by Universal Health Insurance, were abandoned in 2015 largely due to cost concerns...
December 26, 2017: Health Economics, Policy, and Law
https://www.readbyqxmd.com/read/29251648/smartphone-use-by-nurses-in-acute-care-settings
#20
Greir Ander Huck Flynn, Barbara Polivka, Jodi Herron Behr
The use of smartphones in acute care settings remains controversial due to security concerns and personal use. The purposes of this study were to determine (1) the current rates of personal smartphone use by nurses in acute care settings, (2) nurses' preferences regarding the use of smartphone functionality at work, and (3) nurse perceptions of the benefits and drawbacks of smartphone use at work. An online survey of nurses from six acute care facilities within one healthcare system assessed the use of personal smartphones in acute care settings and perceptions of the benefits and drawbacks of smartphone use at work...
December 15, 2017: Computers, Informatics, Nursing: CIN
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