Effectiveness of audit-feedback facilitation for evidence-based practice at an acute care hospital setting

2012 ◽  
Vol 10 (3) ◽  
pp. 283
Author(s):  
E G Oh ◽  
J Y Yoo
Keyword(s):  
Acute Care ◽  
Evidence Based Practice ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
Evidence Based ◽  
Care Hospital

A RANDOMIZED TRIAL TO MEASURE THE OPTIMAL ROLE OF THE PHARMACIST IN PROMOTING EVIDENCE-BASED ANTIBIOTIC USE IN ACUTE CARE HOSPITALS

2001 ◽  
Vol 17 (2) ◽  
pp. 171-180 ◽  
Author(s):  
George Dranitsaris ◽  
Diana Spizzirri ◽  
Monique Pitre ◽  
Allison McGeer
Keyword(s):  
Acute Care ◽  
Broad Spectrum ◽  
Randomized Clinical Trials ◽  
Intervention Group ◽  
Hospital Setting ◽  
Control Group ◽  
Evidence Based ◽  
Care Hospital ◽  
Broad Spectrum Antibiotics ◽  
The Impact

Background: There is a considerable gap between randomized clinical trials and implementing the results into practice. This is particularly relevant in the use of broad-spectrum antibiotics in hospitals. Hospital pharmacists can be effective vehicles for bridging this gap and promoting evidence-based medicine. To determine the most effective way of using the pharmacist in this role, a prospective cefotaxime intervention study was conducted with randomization incorporated into the design as well as patient-related therapeutic outcomes.Methods: A total of 323 patients who were prescribed cefotaxime were randomized into an intervention or nonintervention group where only the former was challenged by pharmacists for inappropriate cefotaxime usage relative to hospital guidelines. The primary outcome was the appropriateness of cefotaxime prescribing between groups. Logistic regression analysis was then used to identify factors that were associated with successful clinical response.Results: Overall, 94% of orders in the intervention group met cefotaxime dosage criteria compared with 86% in the control group (p = .018). However, there was no impact with respect to promoting cefotaxime use for an appropriate indication (81% vs. 80%; p = .67). There was a trend for improved clinical outcomes in patients who received cefotaxime within hospital guidelines (OR = 1.73; p = .31).Conclusions: The pharmacist as a vehicle for promoting the appropriate use of broad-spectrum antibiotics in the acute care hospital setting can improve the dosing of such agents. However, several barriers to optimizing the impact of the pharmacist were implied by the data. Removing these barriers could increase the pharmacists' utility as an agent for improved patient care.

Clean or sterile technique when inserting indwelling urinary catheter: An evaluation of nurses’ and assistant nurses’ interpretations of a guideline at an acute-care hospital in Sweden

2018 ◽  
Vol 39 (2) ◽  
pp. 92-97
Author(s):  
Aysel Kulbay ◽  
Ann Tammelin
Keyword(s):  
Urinary Bladder ◽  
Acute Care ◽  
Urinary Catheter ◽  
Acute Care Hospital ◽  
Evidence Based ◽  
Urinary Catheterization ◽  
Care Hospital ◽  
Urinary Catheters ◽  
Sterile Technique ◽  
Assistant Nurses

Insertion of indwelling urinary catheters should be performed in a way that minimizes the risk of introducing bacteria to the urinary bladder. Nurses and assistant nurses from three departments at an acute-care hospital in Sweden answered a questionnaire about their insertion of urinary catheterization. Of the 563 nurses, 92% answered the questionnaire. Among the 492 who performed catheterization, 58% ( n = 287) said that they followed the hospital guideline. Two-thirds of those following the hospital guideline said that they used clean technique and one-third sterile technique. In all, 82% considered the catheter should be kept sterile while inserted but only 16% described all the prerequisites to achieve this. Over 90% of the respondents performed catheterization less than once a week. Our conclusion is that a guideline should describe every step of catheterization in detail and that an evidence-based process for implementation of the guideline is necessary to achieve uniformity in performance.

Fall Prevention in a Swiss Acute Care Hospital Setting: Reducing Multiple Falls

2006 ◽  
Vol 32 (3) ◽  
pp. 13-22 ◽  
Author(s):  
Koen Milisen ◽  
Courtney W. Brown ◽  
Sabina De Geest
Keyword(s):  
Acute Care ◽  
Fall Prevention ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
Care Hospital

scholarly journals Communication behavior of cognitively impaired older inpatients

2019 ◽  
Vol 52 (S4) ◽  
pp. 264-272
Author(s):  
Eva-Luisa Schnabel ◽  
Hans-Werner Wahl ◽  
Susanne Penger ◽  
Julia Haberstroh
Keyword(s):  
Cognitive Impairment ◽  
Psychometric Properties ◽  
Acute Care ◽  
Older Patients ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
Acute Care Hospitals ◽  
Well Being ◽  
Communication Behavior ◽  
Care Hospital

Abstract Background and objective Acutely ill older patients with cognitive impairment represent a major subgroup in acute care hospitals. In this context, communication plays a crucial role for patients’ well-being, healthcare decisions, and medical outcomes. As validated measures are lacking, we tested the psychometric properties of an observational instrument to assess Communication Behavior in Dementia (CODEM) in the acute care hospital setting. As a novel feature, we were also able to incorporate linguistic and social-contextual measures. Material and methods Data were drawn from a cross-sectional mixed methods study that focused on the occurrence of elderspeak during care interactions in two German acute care hospitals. A total of 43 acutely ill older patients with severe cognitive impairment (CI group, Mage ± SD = 83.6 ± 5.7 years) and 50 without cognitive impairment (CU group, Mage ± SD = 82.1 ± 6.3 years) were observed by trained research assistants during a standardized interview situation and rated afterwards by use of CODEM. Results Factor analysis supported the expected two-factor solution for the CI group, i.e., a verbal content and a nonverbal relationship aspect. Findings of the current study indicated sound psychometric properties of the CODEM instrument including internal consistency, convergent, divergent, and criterion validity. Conclusion CODEM represents a reliable and valid tool to examine the communication behavior of older patients with CI in the acute care hospital setting. Thus, CODEM might serve as an important instrument for researcher and healthcare professionals to describe and improve communication patterns in this environment.

scholarly journals Adopt-a-Hospital Project: An instructional tool for hospital administration

2016 ◽  
Vol 5 (6) ◽  
pp. 63
Author(s):  
Asa B. Wilson
Keyword(s):  
Experiential Learning ◽  
Acute Care ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
Hospital Administration ◽  
Care Hospital ◽  
Health Administration ◽  
Hospital Operations ◽  
Specific Career ◽  
Healthcare Finance

Backgournd: More often than not, university health administration curriculums are generic and are not foundational to a specific career track. This is especially true in relation to the transition from graduation to a hospital administration career progression. The overarching question is, “How does one prepare themselves for senior leadership in an acute care hospital setting?”Objective: A semester-long assignment – Adopt-a-Hospital Project – is discussed in the context of a healthcare finance course as tool for preparing students to think administratively regarding hospital operations. This Project is presented as an academic foundation preparing students for the required semester-long internship placement in an acute care hospital.Results: The Project-Internship sequence has, over a four-year period, demonstrated its value as an academic and experiential learning bridge from the academy to the world of work. Informal, qualitative findings are discussed in terms of a future quantitative study incorporating: (1) preceptor surveys, (2) intern surveys, and (3) focus group feedback.Conclusions: The Project-Internship sequence fosters a link between academic content and experiential learning in an acute care hospital – thereby augmenting one’s post-graduation readiness to pursue a hospital administration career track.

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