Representing events in a clinical environment a case study

Author(s):  
Leendert W.M. Wienhofen ◽  
Andreas D. Landmark
Keyword(s):  

Nursing professionals experiencing incivility and bullying within the workplace are affected physically and emotionally. The sole purpose of the healthcare environment is to provide therapeutic intervention to the ill. Nurses should not anticipate going to work within healthcare facilities to be harassed, disrespected, and threatened. Be it a nurse working within a clinical environment or employed as a nurse educator in an academic setting, incivility and bullying can cause harm. Chapter 1 will provide an overview of the terms incivility and bullying. Uncivil conduct will be examined through a case study involving a perpetrator to provide insight into how a bully thinks and reacts with regard to their own behavior.


2008 ◽  
Vol 24 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Kerri Holzhauser ◽  
Marie Cooke ◽  
Sarah Winch ◽  
Julie Finucane ◽  
Cathy Davis

2020 ◽  
Vol 26 (4) ◽  
pp. 2512-2537 ◽  
Author(s):  
Scott McLachlan ◽  
Evangelia Kyrimi ◽  
Kudakwashe Dube ◽  
Graham Hitman ◽  
Jennifer Simmonds ◽  
...  

There is a strong push towards standardisation of treatment approaches, care processes and documentation of clinical practice. However, confusion persists regarding terminology and description of many clinical care process specifications which this research seeks to resolve by developing a taxonomic characterisation of clinical care process specifications. Literature on clinical care process specifications was analysed, creating the starting point for identifying common characteristics and how each is constructed and used in the clinical setting. A taxonomy for clinical care process specifications is presented. The De Bleser approach to limited clinical care process specifications characterisation was extended and each clinical care process specification is successfully characterised in terms of purpose, core elements and relationship to the other clinical care process specification types. A case study on the diagnosis and treatment of Type 2 Diabetes in the United Kingdom was used to evaluate the taxonomy and demonstrate how the characterisation framework applies. Standardising clinical care process specifications ensures that the format and content are consistent with expectations, can be read more quickly and high-quality information can be recorded about the patient. Standardisation also enables computer interpretability, which is important in integrating Learning Health Systems into the modern clinical environment. The approach presented allows terminologies for clinical care process specifications that were widely used interchangeably to be easily distinguished, thus, eliminating the existing confusion.


2020 ◽  
Vol 75 (5) ◽  
pp. 241-246
Author(s):  
Swati Deulkar ◽  
Shenuka Singh ◽  
Dileep Tiwari

Cross infection in the dental clinical environment remains a low priority in conversations around oral health care despite the high risk of exposure to blood and airborne infections. The aim of this study was to determine the presence of selected pathogens after use of disinfectants on specific dental environmental surfaces at a public oral health facility in KwaZulu-Natal. This was a cross-sectional descriptive case study with a non-experimental design. The dental clinical environment was divided into four zones and 9 dental units were systematically selected. Swabs were collected from the 26 identified areas at specific time intervals (7.00, 9.00, 11.00, and 16.00) after the use of chlorine, ethanol (70% in water) and glutaraldehyde (2%) as surface disinfectants. The collected swab samples were cultured in nutrient agar media for two days at 37°C. The colony forming units were then examined and characterized using the MALDI-TOF spectrometer. Out of the 312 samples taken, 262 (84%) were shown to be bacterial culture positive. The most contaminated areas in the dental environment were around the chair area (86.53%) and the area away from the chair (92%). Glutaraldehyde was found to be more effective than chlorine and ethanol. The study suggests an association between the frequency of cleaning, the type of disinfectant used and the bacterial microbial count on the specified dental environmental surfaces at the identified oral health facility.


Author(s):  
Dawn-Marie Turner ◽  
Sunil Hazari

Wireless technology has broad implications for the healthcare environment. Despite its promise, this new technology has raised questions about security and privacy of sensitive data that is prevalent in healthcare organizations. All healthcare organizations are governed by legislation and regulations, and the implementation of enterprise applications using new technology is comparatively more difficult than in other industries. Using a configuration-idiographic case-study approach, this study investigated challenges faced by two Canadian healthcare organizations. In addition to interviews with management and staff of the organizations, a walk-through was also conducted to observe and collect first-hand data of the implementation of wire-less technology in the clinical environment. In the organizations under examination, it was found that wireless technology is being implemented gradually to augment the wired network. Problems associated with implementing wireless technology in these Canadian organizations are also discussed. Because of different standards in this technology, the two organizations are following different upgrade paths. Based on the data collected, best practices for secure wireless access in these organizations are proposed.


Author(s):  
K. Miller ◽  
R. Kowalski ◽  
S. Coffey-Zern ◽  
G. Ebbert ◽  
J. Learish ◽  
...  

The demand for usability testing is becoming increasingly important as healthcare moves toward a commitment to zero patient harm and higher value of care provided. Usability testing and simulation, techniques used in user-centered interaction design to evaluate healthcare systems, promote safe, high-quality care for patients. We propose the concept of a “Mobile Usability Lab”, a novel way to conduct usability testing system-wide. The Mobile Usability Lab describes a unique opportunity to step away from the standard state-of-the-art usability lab and take a creative approach to usability testing. To demonstrate the utility of this concept, we present a case study detailing a hospital-wide comparative device evaluation of new defibrillators. We recommend that research and clinical teams explore the concept of a mobile usability lab to evaluate products in the clinical environment. This work can reduce preventable harm through the optimization of health care delivery.


2013 ◽  
Vol 04 (03) ◽  
pp. 317-330 ◽  
Author(s):  
JC. McClay ◽  
JR. Windle ◽  
T. Windle

SummaryObjective: The objective of this case report is to evaluate the importance of specialized domain knowledge when designing and using structured templated notes in a clinical environment.Methods: To analyze the impact of specialization on structured note generation we compared notes generated for three scenarios: 1) We compared the templated history of present illness (HPI) for patients presenting with a dermatology concern to the dermatologist versus the emergency department. 2) We compared the evaluation of chest pain by ED physicians versus cardiologists. 3) Finally, we compared the data elements asked for in the evaluation of the gastrointestinal system between cardiologists and the liver transplant service (LTS). We used the SNOMED CT representation via BioPortal to evaluate specificity and grouping between data elements and specialized physician groups.Results: We found few similarities in structured data elements designed by and for the specific physician groups. The distinctness represented both differences in granularity as well as fundamental differences in data elements requested. When compared to ED physicians, dermatologists had different and more granular elements while cardiologists requested much more granular data. Comparing cardiologists and LTS, there were differences in the data elements requested.Conclusion: This case study supports the importance of domain knowledge in EHR design and implementation. That different specialities should want and use different information is well supported by cognitive science literature. Despite this, it is rare for domain knowledge to be considered in EHR implementation. Physicians with correct domain knowledge should be involved in the design process of templated notes.


2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Krista Wollny ◽  
Amy Metcalfe ◽  
Deborah McNeil ◽  
Karen Benzies ◽  
Tolulope Sajobi ◽  
...  

Abstract Focus of Presentation Multivariable regression models can be used to answer a variety of clinical questions. The two main objectives of regression models are to either 1) understand an association between one or more exposures and an outcome; or 2) predict future outcomes based on certain exposures or variables. To simplify this, we will consider the former causal analysis, and the latter prediction analysis. This presentation will explain the steps in model development and assessment using a clinical case study, highlighting the similarities and differences. This presentation is aimed at trainees. Findings The key differences between causal and prediction models include: the purpose and research questions, power calculations, variable selection, model specification, testing model fit, and the desired outcome of each model. The case study demonstrates these differences, while working through a causal and prediction model with similar clinical questions. Conclusions/Implications It is important for researchers to consider the purpose of their research question and to tailor the model accordingly. This will guide the model development and interpretation, which are different for causal and prediction analyses. Key messages A thorough understanding of the types of models available, their assumptions, and the process of model development and assessment is essential to conducting research that is valid and applicable to the clinical environment, enabling knowledge translation.


2009 ◽  
pp. 303-312
Author(s):  
Dawn-Marie Turner ◽  
Sunil Hazari

Wireless technology has broad implications for the healthcare environment. Despite its promise, this new technology has raised questions about security and privacy of sensitive data that is prevalent in healthcare organizations. All healthcare organizations are governed by legislation and regulations, and the implementation of enterprise applications using new technology is comparatively more difficult than in other industries. Using a configuration-idiographic case-study approach, this study investigated challenges faced by two Canadian healthcare organizations. In addition to interviews with management and staff of the organizations, a walk-through was also conducted to observe and collect first-hand data of the implementation of wireless technology in the clinical environment. In the organizations under examination, it was found that wireless technology is being implemented gradually to augment the wired network. Problems associated with implementing wireless technology in these Canadian organizations are also discussed. Because of different standards in this technology, the two organizations are following different upgrade paths. Based on the data collected, best practices for secure wireless access in these organizations are proposed.


2014 ◽  
Vol 38 (01) ◽  
pp. 102-129
Author(s):  
ALBERTO MARTÍN ÁLVAREZ ◽  
EUDALD CORTINA ORERO

AbstractUsing interviews with former militants and previously unpublished documents, this article traces the genesis and internal dynamics of the Ejército Revolucionario del Pueblo (People's Revolutionary Army, ERP) in El Salvador during the early years of its existence (1970–6). This period was marked by the inability of the ERP to maintain internal coherence or any consensus on revolutionary strategy, which led to a series of splits and internal fights over control of the organisation. The evidence marshalled in this case study sheds new light on the origins of the armed Salvadorean Left and thus contributes to a wider understanding of the processes of formation and internal dynamics of armed left-wing groups that emerged from the 1960s onwards in Latin America.


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