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https://www.readbyqxmd.com/read/29691950/adapting-evidence-based-clinical-practice-guidelines-at-university-teaching-hospitals-a-model-for-the-eastern-mediterranean-region
#1
Yasser S Amer, Hayfaa A Wahabi, Manal M Abou Elkheir, Ghada A Bawazeer, Shaikh M Iqbal, Maher A Titi, Aishah Ekhzaimy, Khalid A Alswat, Rasmieh A Alzeidan, Lubna A Al-Ansary
RATIONALE, AIMS, AND OBJECTIVES: Clinical practice guidelines (CPGs) are significant tools for evidence-based health care quality improvement. The CPG program at King Saud University was launched as a quality improvement program to fulfil the international accreditation standards. This program was a collaboration between the Research Chair for Evidence-Based Healthcare and Knowledge Translation and the Quality Management Department. This study aims to develop a fast-track method for adaptation of evidence-based CPGs and describe results of the program...
April 24, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29691843/a-systems-approach-to-identify-factors-influencing-adverse-drug-events-in-nursing-homes
#2
Ali Azeez Al-Jumaili, William R Doucette
The objectives of the study were to identify the incidence rate and characteristics of adverse drug events (ADEs) in nursing homes (NHs) using the ADE trigger tool and to evaluate the relationships between resident and facility work system factors and incidence of ADEs using the System Engineering Initiative for Patient Safety (SEIPS) model. The study used 2 observational quantitative methods, retrospective resident chart extraction, and surveys. The participating staff included Directors of nursing, registered nurses, certified nurse assistants (CNAs)...
April 24, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29691269/implementation-of-a-pharmacy-managed-program-for-the-transition-of-chemotherapy-to-the-outpatient-setting
#3
Ali McBride, Christopher J Campen, James Camamo, Marie Maloney, Daniel Persky, Sandra E Kurtin, Nikki L Barket, Ravitharan Krishnadasan, Emad Elquza, Faiz Anwer, Kurt Weibel
PURPOSE: Implementation of a pharmacy-managed program for the transition of chemotherapy to the outpatient setting is described. SUMMARY: The University of Arizona Cancer Center and Banner-University Medical Center Tucson are affiliated not-for-profit academic medical centers in Tucson, Arizona, whose facilities include a hospital and ambulatory care clinics that maintain 3 outpatient infusion centers. The cancer center pharmacy currently employs 25 pharmacists, with 4 clinical pharmacists serving both the inpatient and outpatient treatment sites...
May 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29691201/identifying-unmet-treatment-needs-for-patients-with-osteoporotic-fracture-feasibility-study-for-an-electronic-clinical-surveillance-system
#4
Fong-Ci Lin, Chen-Yu Wang, Rung Ji Shang, Fei-Yuan Hsiao, Mei-Shu Lin, Kuan-Yu Hung, Jui Wang, Zhen-Fang Lin, Feipei Lai, Li-Jiuan Shen, Chih-Fen Huang
BACKGROUND: Traditional clinical surveillance relied on the results from clinical trials and observational studies of administrative databases. However, these studies not only required many valuable resources but also faced a very long time lag. OBJECTIVE: This study aimed to illustrate a practical application of the National Taiwan University Hospital Clinical Surveillance System (NCSS) in the identification of patients with an osteoporotic fracture and to provide a high reusability infrastructure for longitudinal clinical data...
April 24, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29691122/emr-based-medical-knowledge-representation-and-inference-via-markov-random-fields-and-distributed-representation-learning
#5
Chao Zhao, Jingchi Jiang, Yi Guan, Xitong Guo, Bin He
OBJECTIVE: Electronic medical records (EMRs) contain medical knowledge that can be used for clinical decision support (CDS). Our objective is to develop a general system that can extract and represent knowledge contained in EMRs to support three CDS tasks-test recommendation, initial diagnosis, and treatment plan recommendation-given the condition of a patient. METHODS: We extracted four kinds of medical entities from records and constructed an EMR-based medical knowledge network (EMKN), in which nodes are entities and edges reflect their co-occurrence in a record...
April 22, 2018: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/29689388/neutrophil-and-platelet-to-lymphocyte-ratios-in-associating-with-blood-glucose-admission-predict-the-functional-outcomes-of-patients-with-primary-brainstem-hemorrhage
#6
F Zhang, H Li, C Tao, J Zheng, X Hu, S Lin, J Qian, C You, M Yang
BACKGROUND: Due to lack of markers for predicting the prognosis as well as the under mechanism is unrevealed, patients with primary brainstem hemorrhage (PBH) were currently treated by multi-strategies but most of them have poor outcomes by comparing with supratentorial intracranial hemorrhage patients. Recently, it has been reported that the ratio of neutrophil to lymphocyte (NLR) represents a novel composite inflammatory marker to predict the prognosis of patients with intracranial hemorrhage, where majority are supratentorial hemorrhage...
April 21, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29689040/-potentially-inappropriate-prescriptions-in-elderly-outpatiens-results-of-implicit-criteria-applied-by-clinical-pharmacists
#7
Concetta Di Giorgio, Alessio Provenzani, Piera Polidori
BACKGROUND: Management of therapy in elderly patients is a critical issue in primary care. The physiopathological status is usually complex, and the prescription of multiple drugs is typically required, with a consequent higher risk of adverse effects. Many tools have been developed to cope with this problem, and identify drugs that are inappropriate in the elderly. The objective of the study was to evaluate the appropriateness of therapies in the elderly according to implicit criteria...
April 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29688905/impact-of-adoption-of-a-comprehensive-electronic-health-record-on-nursing-work-and-caring-efficacy
#8
Elizabeth Schenk, Ruth Schleyer, Cami R Jones, Sarah Fincham, Kenn B Daratha, Karen A Monsen
Nurses in acute care settings are affected by the technologies they use, including electronic health records. This study investigated the impacts of adoption of a comprehensive electronic health record by measuring nursing locations and interventions in three units before and 12 months after adoption. Time-motion methodology with a handheld recording platform based on Omaha System standardized terminology was used to collect location and intervention data. In addition, investigators administered the Caring Efficacy Scale to better understand the effects of the electronic health record on nursing care efficacy...
April 23, 2018: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/29688461/transition-to-a-new-electronic-health-record-and-pediatric-medication-safety-lessons-learned-in-pediatrics-within-a-large-academic-health-system
#9
Kimberly Whalen, Emily Lynch, Iman Moawad, Tanya John, Denise Lozowski, Brian M Cummings
Objective: While the electronic health record (EHR) has become a standard of care, pediatric patients pose a unique set of risks in adult-oriented systems. We describe medication safety and implementation challenges and solutions in the pediatric population of a large academic center transitioning its EHR to Epic. Methods: Examination of the roll-out of a new EHR in a mixed neonatal, pediatric and adult tertiary care center with staggered implementation. We followed the voluntarily reported medication error rate for the neonatal and pediatric subsets and specifically monitored the first 3 months after the roll-out of the new EHR...
April 23, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29688092/predictors-of-future-exacerbations-in-a-multi-ethnic-asian-population-with-asthma
#10
Tunn Ren Tay, Hang Siang Wong, Augustine Tee
OBJECTIVE: Exacerbations are important outcomes in asthma. Risk factors for exacerbations may differ in different populations. Although various demographic and clinical variables were examined in previous studies on exacerbation risks in asthma, important variables such as ethnicity, adherence, and medication titration were not included. This study examined independent predictors of future exacerbations in a multi-ethnic asthma population in Asia, while including the variables of ethnicity, medication adherence, and medication change in our analysis...
April 24, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29687454/interventions-for-implementation-of-thromboprophylaxis-in-hospitalized-patients-at-risk-for-venous-thromboembolism
#11
REVIEW
Susan R Kahn, David R Morrison, Gisèle Diendéré, Alexandre Piché, Kristian B Filion, Adi J Klil-Drori, James D Douketis, Jessica Emed, André Roussin, Vicky Tagalakis, Martin Morris, William Geerts
BACKGROUND: Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in hospitalized patients. While numerous randomized controlled trials (RCTs) have shown that the appropriate use of thromboprophylaxis in hospitalized patients at risk for VTE is safe, effective, and cost-effective, thromboprophylaxis remains underused or inappropriately used. Our previous review suggested that system-wide interventions, such as education, alerts, and multifaceted interventions were more effective at improving the prescribing of thromboprophylaxis than relying on individual providers' behaviors...
April 24, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29687332/sometimes-determination-and-compromise-thwart-success-lessons-learned-from-an-effort-to-study-copying-and-pasting-in-the-electronic-medical-record
#12
Jane P Gagliardi, Mariah J Rudd
No abstract text is available yet for this article.
April 23, 2018: Perspectives on Medical Education
https://www.readbyqxmd.com/read/29685564/postoperative-outcome-of-the-modified-brostr%C3%A3-m-procedure-in-the-active-duty-military-population-a-retrospective-cohort-study
#13
Thomas J Melton, Joseph H Dannenbaum, Nicholas J Drayer, Justin Robbins, Paul M Ryan
Ankle sprains are common injuries and typically treated conservatively. Chronic ankle instability, however, can require surgery when nonoperative measures fail. We evaluated the clinical outcomes of an active duty population in a retrospective study of patients who had undergone a modified Broström procedure at our facility from January 2010 through April 2014 by a single surgeon. The electronic medical records and Army E-profile database were reviewed to determine whether the patients had returned to active duty and whether they had any permanent postoperative lower extremity activity restrictions...
May 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29684904/excess-hospitalization-expenses-attributable-to-type-2-diabetes-mellitus-in-singapore
#14
May Ee Png, Joanne Yoong, Chuen Seng Tan, Kee Seng Chia
OBJECTIVES: To estimate the excess hospitalization expenses attributable to type 2 diabetes mellitus (T2DM) in a high-income Asian country from the health system perspective and the patient perspective. METHODS: Electronic medical records from a tertiary academic hospital in Singapore from 2012 to 2013 were used to create propensity score-matched cohorts with and without T2DM on the basis of their entry characteristics. A two-part model was then used to control for remaining differences between the cohorts...
April 20, 2018: Value in Health Regional Issues
https://www.readbyqxmd.com/read/29684329/vision-outcomes-following-anti-vascular-endothelial-growth-factor-treatment-of-diabetic-macular-edema-in-clinical-practice
#15
Nancy M Holekamp, Joanna Campbell, Arghavan Almony, Herbert Ingraham, Steven Marks, Hitesh Chandwani, Ashley L Cole, Szilárd Kiss
PURPOSE: To determine monitoring and treatment patterns, and vision outcomes in real-world patients initiating anti-vascular endothelial growth factor (anti-VEGF) therapy for diabetic macular edema (DME). DESIGN: Retrospective interventional cohort study. METHODS: SETTING: Electronic medical record analysis of Geisinger Health System data. STUDY POPULATION: 110 patients (121 study eyes) initiating intravitreal ranibizumab or bevacizumab for DME during January 2007‒May 2012, with baseline corrected visual acuity of 20/40‒20/320, and ≥1 ophthalmologist visits during follow-up...
April 20, 2018: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29684250/electronic-medication-administration-records-in-long-term-care-facilities-a-scoping-review
#16
REVIEW
Andrew E C Fuller, Lisa M Guirguis, Cheryl A Sadowski, Mark J Makowsky
OBJECTIVES: To map the extent, range, and nature of research on the effectiveness, level of use, and perceptions about electronic medication administration records (eMARs) in long-term care facilities (LTCFs) and identify gaps in current knowledge and priority areas for future research. DESIGN: Scoping review of quantitative and qualitative literature. SETTING: Literature review. PARTICIPANTS: Original research relating to eMAR in LTCF was eligible for inclusion...
April 23, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29683249/hypertension-control-after-an-initial-cardiac-event-among-medicare-patients-with-diabetes-mellitus-a-multidisciplinary-group-practice-observational-study
#17
Ashish Chaddha, Maureen A Smith, Mari Palta, Heather M Johnson
Patients with diabetes mellitus and cardiovascular disease have a high risk of mortality and/or recurrent cardiovascular events. Hypertension control is critical for secondary prevention of cardiovascular events. The objective was to determine rates and predictors of achieving hypertension control among Medicare patients with diabetes and uncontrolled hypertension after hospital discharge for an initial cardiac event. A retrospective analysis of linked electronic health record and Medicare data was performed...
April 23, 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29682740/implications-of-false-positive-results-for-future-cancer-screenings
#18
Glen B Taksler, Nancy L Keating, Michael B Rothberg
BACKGROUND: False-positive cancer screening results may affect a patient's willingness to obtain future screening. METHODS: The authors conducted logistic regression analysis of 450,484 person-years of electronic medical records (2006-2015) in 92,405 individuals aged 50 to 75 years. Exposures were false-positive breast, prostate, or colorectal cancer screening test results (repeat breast imaging or negative breast biopsy ≤3 months after screening mammography, repeat prostate-specific antigen [PSA] test ≤3 months after PSA test result ≥4...
April 23, 2018: Cancer
https://www.readbyqxmd.com/read/29682132/creating-a-foundation-for-implementing-an-electronic-health-records-ehr-integrated-social-knowledge-networking-skn-system-on-medication-reconciliation
#19
P Rangachari, K C Dellsperger, D Fallaw, I Davis, M Sumner, W Ray, S Fiedler, T Nguyen, R Rethemeyer
Background: In fall 2016, Augusta University received a two-year grant from AHRQ, to implement a Social Knowledge Networking (SKN) system for enabling its health system, AU-Health, to progress from "limited use" of EHR Medication Reconciliation (MedRec) Technology, to "meaningful use." Phase 1 sought to identify a comprehensive set of issues related to EHR MedRec encountered by practitioners at AU-Health. These efforts helped develop a Reporting Tool , which, along with a Discussion Tool , was incorporated into the AU-Health EHR, at the end of Phase 1...
April 2018: Journal of Hospital Administration
https://www.readbyqxmd.com/read/29681028/the-datafication-of-everything-even-toilets
#20
Kwok-Chan Lun
Health informatics has benefitted from the development of Info-Communications Technology (ICT) over the last fifty years. Advances in ICT in healthcare have now started to spur advances in Data Technology as hospital information systems, electronic health and medical records, mobile devices, social media and Internet Of Things (IOT) are making a substantial impact on the generation of data. It is timely for healthcare institutions to recognize data as a corporate asset and promote a data-driven culture within the institution...
April 22, 2018: Yearbook of Medical Informatics
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