Implementation of additional prescribing authorization among oncology pharmacists in Alberta

2018 ◽  
Vol 25 (3) ◽  
pp. 584-598 ◽  
Author(s):  
Bianca Au ◽  
Deonne Dersch-Mills ◽  
Sunita Ghosh ◽  
Jennifer Jupp ◽  
Carole Chambers ◽  
...  
Keyword(s):  
Ambulatory Care ◽  
Clinical Work ◽  
Median Number ◽  
Prescribing Practices ◽  
Patient Assessment ◽  
Ambulatory Patient ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Self Confidence

Purpose To describe the practice settings and prescribing practices of oncology pharmacists with additional prescribing authorization. Methods A descriptive, cross-sectional survey of all oncology pharmacists in Alberta was conducted using a web-based questionnaire over four weeks between March and April 2016. Pharmacists were identified from the Cancer Services Pharmacy Directory and leadership staff in Alberta Health Services. Descriptive statistics were used to describe the practice setting, prescribing practices, motivators to apply for additional prescribing authorization, and the facilitators and barriers of prescribing. Logistic regression was used to explore factors associated with having additional prescribing authorization. Results The overall response rate was 41% (71 of 175 pharmacists). Oncology pharmacists with additional prescribing authorization made up 38% of respondents. They primarily worked in urban, tertiary cancer centers, and practiced in ambulatory care. The top 3 clinical activities they participated in were medication reconciliation, medication counseling/education, and ambulatory patient assessment. Respondents thought additional prescribing authorization was most useful for ambulatory patient assessment and follow-up. Antiemetics were prescribed the most often. The median number of prescriptions written in an average week of clinical work was 5. Competence, self-confidence, and the potential impact on patient care/perceived impact on work environment were the strongest facilitators of prescribing. The strongest motivators to apply for additional prescribing authorization were relevancy to practice, the potential for increased efficiency, and advancing the profession. Conclusion The current majority of oncology pharmacist prescribing in Alberta occurs in ambulatory care with a large focus on antiemetic prescribing. Pharmacists found additional prescribing authorization most useful for ambulatory patient assessment and follow-up.

scholarly journals Validity of World Health Organisation prescribing indicators in Namibia’s primary healthcare: findings and implications

2018 ◽  
Vol 31 (5) ◽  
pp. 338-345 ◽  
Author(s):  
Q Niaz ◽  
B Godman ◽  
A Massele ◽  
S Campbell ◽  
A Kurdi ◽  
...  
Keyword(s):  
Ambulatory Care ◽  
Treatment Guidelines ◽  
Survey Design ◽  
World Health ◽  
Antibiotic Prescribing ◽  
Medicine Use ◽  
Prescribing Practices ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Significant Independent Risk Factor

Abstract Objective World Health Organization/International Network of Rational use of Drugs (WHO/INRUD) indicators are widely used to assess medicine use. However, there is limited evidence on their validity in Namibia’s primary health care (PHC) to assess the quality of prescribing. Consequently, our aim was to address this. Design, setting, participants and interventions An analytical cross-sectional survey design was used to examine and validate WHO/INRUD indicators in out-patient units of two PHC facilities and one hospital in Namibia from 1 February 2015 to 31 July 2015. The validity of the indicators was determined using two-by-two tables against compliance to the Namibian standard treatment guidelines (NSTG). The receiver operator characteristics for the WHO/INRUD indicators were plotted to determine their accuracy as predictors of compliance to agreed standards. A multivariate logistic model was constructed to independently determine the prediction of each indicator. Main outcomes and results Out of 1243 prescriptions; compliance to NSTG prescribing in ambulatory care was sub-optimal (target was >80%). Three of the four WHO/INRUD indicators did not meet Namibian or WHO targets: antibiotic prescribing, average number of medicines per prescription and generic prescribing. The majority of the indicators had low sensitivity and/or specificity. All WHO/INRUD indicators had poor accuracy in predicting rational prescribing. The antibiotic prescribing indicator was the only covariate that was a significant independent risk factor for compliance to NSTGs. Conclusion WHO/INRUD indicators showed poor accuracy in assessing prescribing practices in ambulatory care in Namibia. There is need for appropriate models and/or criteria to optimize medicine use in ambulatory care in the future.

Prevalence and determinant factors of exclusive breastfeeding practices among mothers in Marrakesh province, Morocco: A cross- sectional survey

2021 ◽  
pp. 1-11
Author(s):  
Soufiane El Moussaoui ◽  
Kamal Kaoutar ◽  
Ahmed Chetoui ◽  
Abdeslam El Kardoudi ◽  
Fatiha Chigr ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Multivariate Logistic Regression ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Breastfeeding Practices ◽  
Survey Report ◽  
Duration Of Breastfeeding ◽  
Breastfeeding Practice

BACKGROUND: Exclusive breastfeeding is the best form of nutrition for infants during the first 6 months of life. Nevertheless, the practice of breastfeeding is currently declining throughout the world. OBJECTIVE: The objective of this study was to assess the prevalence of exclusive breastfeeding (EBF) practice and its associated factors among mothers living in Marrakesh province, Morocco. METHODS: The data were collected using an interviewer administered questionnaire. Both bivariate and multivariate logistic regression analyses were used to identify factors associated with exclusive breastfeeding practice. RESULTS: Prevalence of exclusive breastfeeding was 50.2%. Mothers with age more than 30 years, residing in rural area, receiving counseling related breastfeeding during antenatal follow up and having knowledge about duration of breastfeeding were more likely to practice exclusive breastfeeding than their counterparts. CONCLUSION: Although the prevalence of breastfeeding in Marrakesh was higher than the last national survey report but it is still insufficient. These findings have to stress authorities and deciders to sensitize mothers and future mothers to increase exclusive breastfeeding practice notably through the involvement of health professionals.

scholarly journals Support received by family members before, at and after an ill person’s death

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna O’Sullivan ◽  
Anette Alvariza ◽  
Joakim Öhlén ◽  
Cecilia Larsdotter
Keyword(s):  
Survey Design ◽  
Family Members ◽  
Time Of Death ◽  
Healthcare Staff ◽  
Care Needs ◽  
Advanced Illness ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Bereaved Family

Abstract Background It is widely recognised, that family members are central to care of people with advanced illness, and that support should be provided to all family members in need thereof. The aim of this study was to investigate family members’ experiences of support received during the last three months of life, at the time of death and after the death of a person with advanced illness. Methods A retrospective cross-sectional survey design was employed, using the VOICES(SF) questionnaire and multiple methods for data analyses. The sample consisted of 485 bereaved family members (aged: 20–90 years old, 70% women) of people who died in hospital between August 2016-April 2017. Results Of the family members, 58,8% reported they had received enough help and support during the illness, whereas 30,2% had not. Family members’ comments about support during the illness were mainly related to care the ill person had or had not received, rather than about support they themselves received. Of all family members, 52,8% reported having had enough support at the time of the ill person’s death. Related to support at death, 14,6% reported that the imminence of death was not clear, which was described as having affected their opportunity to be with the dying person at the time of death. Of all, 25,2% had a follow-up conversation after the death, 48% did not and did not want to, and 21% had no follow-up conversation, but would have liked one. A follow-up conversation was described as helpful for the bereavement process, and disappointment was expressed when not receiving support after the death. Conclusions Family members’ experiences of support were partly related to whether the ill person’s care needs were fulfilled. Healthcare staff expressing empathy and respect in the care of dying people and their family members were important for family members’ experiences of support. Family members’ difficulty recognising that death was imminent and the importance of healthcare staff providing them with clear information were expressed in connection with support at death. Follow-up conversations were valued by family members, especially if with a healthcare professional who was present at the time of death.

scholarly journals Determinants of Method Switching among Social Franchise Clients Who Discontinued the Use of Intrauterine Contraceptive Device

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Waqas Hameed ◽  
Syed Khurram Azmat ◽  
Moazzam Ali ◽  
Wajahat Hussain ◽  
Ghulam Mustafa ◽  
...  
Keyword(s):  
User Satisfaction ◽  
Intrauterine Contraceptive Device ◽  
Contraceptive Device ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Contraceptive Usage ◽  
Social Franchise ◽  
Intrauterine Contraceptive ◽  
Contraceptive Discontinuation

Introduction. Women who do not switch to alternate methods after contraceptive discontinuation, for reasons other than the desire to get pregnant or not needing it, are at obvious risk for unplanned pregnancies or unwanted births. This paper examines the factors that influence women to switch from Intrauterine Contraceptive Device (IUCD) to other methods instead of terminating contraceptive usage altogether.Methods. The data used for this study comes from a larger cross-sectional survey conducted in nine (9) randomly selected districts of Sindh and Punjab provinces of Pakistan, during January 2011. Using Stata 11.2, we analyzed data on 333 women, who reported the removal of IUCDs due to reasons other than the desire to get pregnant.Results. We found that 39.9% of the women do not switch to another method of contraception within one month after IUCD discontinuation. Use of contraception before IUCD insertion increases the odds for method switching by 2.26 times after removal. Similarly, postremoval follow-up by community health worker doubles (OR = 2.0) the chances of method switching. Compared with women who received free IUCD service (via voucher scheme), the method switching is 2.01 times higher among women who had paid for IUCD insertion.Conclusion. To increase the likelihood of method switching among IUCD discontinuers this study emphasizes the need for postremoval client counseling, follow-up by healthcare provider, improved choices to a wider range of contraceptives for poor clients, and user satisfaction.

Pseudomonas aeruginosa

2015 ◽  
Vol 105 (2) ◽  
pp. 125-129 ◽  
Author(s):  
Heather Young ◽  
Bryan Knepper ◽  
Whitney Hernandez ◽  
Asaf Shor ◽  
Merribeth Bruntz ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Glycosylated Hemoglobin ◽  
Operative Procedure ◽  
Empiric Therapy ◽  
Median Number ◽  
Diabetic Patients ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Antibiotic Drugs ◽  
Tobacco Abuse

Background Pseudomonas aeruginosa has traditionally been considered a common pathogen in diabetic foot infection (DFI), yet the 2012 Infectious Diseases Society of America guideline for DFI states that “empiric therapy directed at P aeruginosa is usually unnecessary.” The objective of this study was to evaluate the frequency of P aeruginosa isolated from bone or tissue cultures from patients with DFI. Methods This study is a cross-sectional survey of diabetic patients presenting with a foot infection to an urban county hospital between July 1, 2012, and December 31, 2013. All of the patients had at least one debridement procedure during which tissue or bone cultures from operative or bedside debridements were obtained. The χ2 test and the t test of means were used to determine relationships between variables and the frequency of P aeruginosa in culture. Results The median number of bacteria isolated from DFI was two. Streptococcus spp and Staphylococcus aureus were the most commonly isolated organisms; P aeruginosa was isolated in only five of 112 patients (4.5%). The presence of P aeruginosa was not associated with the patient's age, glycosylated hemoglobin level, tobacco abuse, the presence of osteomyelitis, a prescription for antibiotic drugs in the preceding 3 months, or the type of operative procedure. Conclusions Pseudomonas aeruginosa was an infrequent isolate from DFI in this urban, underserved diabetic population. The presence of P aeruginosa was not associated with any measured risk factors. By introducing a clinical practice guideline, we hope to discourage frontline providers from using routine antipseudomonal antibiotic drugs for DFI.

scholarly journals The Austrian Osteopathic Practitioners Estimates and RAtes (OPERA): a cross-sectional survey

2021 ◽  
Author(s):  
Patrick L.S. van Dun ◽  
Lorenzo Arcuri ◽  
Johan Verbeeck ◽  
Jorge E. Esteves ◽  
Francesco Cerritelli
Keyword(s):  
Median Number ◽  
Diagnostic Techniques ◽  
Cervical Region ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Policy Makers ◽  
Treatment Techniques ◽  
New Information ◽  
Almost All ◽  
English Opera

Abstract Background: Since the previous survey of the osteopathic profession in Austria was almost a decade ago, an update was necessary. The Osteopathic Practitioners Estimates and RAtes (OPERA) project was developed as a Europe-based survey, whereby an updated profile of the profession not only provides new data for Austria, but also allows for a clear comparison with other European countries. Methods: A voluntary, online-based, closed-ended survey was distributed across Austria in the period between April and August 2020. The original English OPERA-questionnaire, composed of 52 questions in seven sections, was formally translated in German and adapted to the Austrian situation. Recruitment was performed through social-media and an e-based campaign.Results: The survey was completed by 338 individuals, of which 239 (71%) were female, and the median age was 40-49 years. Almost all respondents had preliminary healthcare training, mainly in physiotherapy (72%). The majority of respondents were self-employed (88%) and working as sole practitioners (54%). The median number of consultations per week was 21-25 and the majority of respondents scheduled 46-60 minutes for each consultation (69%). The most commonly used diagnostic techniques were: palpation of position/structure, palpation of tenderness and visual inspection. The most commonly used treatment techniques were cranial, visceral and articulatory/mobilisation techniques. The majority of patients estimated by respondents consulted an osteopath for musculoskeletal complaints mainly localised in the lumbar and cervical region. Although the majority of respondents experience a strong osteopathic identity, only a small proportion (17%) advertise themselves exclusively as osteopaths. Conclusions: This study represents the first published document to determine the characteristics of the osteopathic practitioners in Austria using large, national data. It provides new information on where, how, and by whom osteopathic care is delivered. The information provided may contribute to the evidence used by stakeholders and policy makers for the future regulation of the profession in Austria.

scholarly journals Knowledge, Attitude & Practice Among Psoriasis Patients in India Towards Teledermatology During COVID-19 Pandemic

2021 ◽  
Vol 6 (4) ◽  
pp. 01-13
Author(s):  
Archana Mavoori ◽  
Sudha Bala ◽  
Rajiv Kumar Bandaru ◽  
Aruna Kumari Yerra
Keyword(s):  
Teaching Hospital ◽  
Tertiary Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Attitude And Practice ◽  
Knowledge And Attitude ◽  
Knowledge Attitude And Practice

Background: The current COVID-19 pandemic has imposed upon the entire community norms of social distancing and home quarantine. Follow up consultations in these times can be made through teledermatology through smart phones. Success of this technology in these hours of crisis depends upon the knowledge, attitude and behaviour of patients towards teledermatology. Follow up consultations done through teleconsultations will decrease risk of exposure to COVID-19 among psoriasis patients who need frequent follow ups. Aim: The main objective of this study is to assess the awareness, knowledge, attitude and practice of teledermatology through teledermatology among psoriasis patients at a tertiary care teaching hospital. Materials and Methods: A cross-sectional survey, from Psoriasis Clinic registry maintained in the outpatient department of DVL of a tertiary care teaching hospital in India is conducted. A pre-validated self-administered questionnaire is used for the survey to assess knowledge, attitude and practice of teledermatology. Analysis will be done as per study objectives using descriptive statistics for quantitative data and content analysis for qualitative data. Results: Out of 150 patients, 87(58%) were males and females were 63(42%). Most common age group to participate in the study was 36-45 years- 43(28.7%). Majority of participants were educated up to –graduate 53(35.3%). Males had higher knowledge and attitude scores compared to females. Most of the patients found using teleconsutations easy and convenient. Conclusion: Teledermatology is the need of the hour to be implemented in these hours of COVID-19 pandemic.

scholarly journals Methods of conduct and reporting of living systematic reviews: a protocol for a living methodological survey

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 221 ◽  
Author(s):  
Assem M. Khamis ◽  
Lara A. Kahale ◽  
Hector Pardo-Hernandez ◽  
Holger J. Schünemann ◽  
Elie A. Akl
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Evidence Synthesis ◽  
Cochrane Library ◽  
Cross Sectional Survey ◽  
Systematic Review Methodology ◽  
Cross Sectional ◽  
Prospective Longitudinal ◽  
Over Time

Background: The living systematic review (LSR) is an emerging approach for improved evidence synthesis that uses continual updating to include relevant new evidence as soon as it is published. The objectives of this study are to: 1) assess the methods of conduct and reporting of living systematic reviews using a living study approach; and 2) describe the life cycle of living systematic reviews, i.e., describe the changes over time to their methods and findings. Methods: For objective 1, we will begin by conducting a cross-sectional survey and then update its findings every 6 months by including newly published LSRs. For objective 2, we will conduct a prospective longitudinal follow-up of the cohort of included LSRs. To identify LSRs, we will continually search the following electronic databases: Medline, EMBASE and the Cochrane library. We will also contact groups conducting LSRs to identify eligible studies that we might have missed. We will follow the standard systematic review methodology for study selection and data abstraction. For each LSR update, we will abstract information on the following: 1) general characteristics, 2) systematic review methodology, 3) living approach methodology, 4) results, and 5) editorial and publication processes. We will update the findings of both the surveys and the longitudinal follow-up of included LSRs every 6 months. In addition, we will identify articles addressing LSR methods to be included in an ‘LSR methods repository’. Conclusion: The proposed living methodological survey will allow us to monitor how the methods of conduct, and reporting as well as the findings of LSRs change over time. Ultimately this should help with ensuring the quality and transparency of LSRs.

A Follow-Up Study of the Indicators of Teaching Presence Critical to Students in Online Courses

2013 ◽  
pp. 67-83 ◽  
Author(s):  
Kathleen Sheridan ◽  
Melissa A. Kelly ◽  
David T. Bentz
Keyword(s):  
Graduate Students ◽  
Undergraduate Students ◽  
Online Courses ◽  
Survey Design ◽  
Teaching Presence ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Follow Up Study

The purpose of the study presented in this chapter was to examine students’ perceptions of the importance of various indicators of teaching presence for their success in online courses. A cross-sectional survey design was used to identify the indicators that students perceived to be most important and to determine whether there were potential differences between graduate students and undergraduate students in terms of the students’ perceptions. Although the indicators that students rated as most important were similar for both groups of students, there were statistically significant differences for a few of the indicators. Students’ comments suggested additional indicators and provided insights about the importance of dispositions in online courses.

scholarly journals Are Further Interventions Needed to Prevent and Manage Hospital-Acquired Hyponatraemia? A Nationwide Cross-Sectional Survey of IV Fluid Prescribing Practices

2020 ◽  
Vol 9 (9) ◽  
pp. 2790
Author(s):  
Per Sindahl ◽  
Christian Overgaard-Steensen ◽  
Helle Wallach-Kildemoes ◽  
Marie Louise De Bruin ◽  
Hubert GM Leufkens ◽  
...  
Keyword(s):  
Emergency Department ◽  
Inappropriate Prescribing ◽  
Plasma Sodium ◽  
Prescribing Practices ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Clinical Scenarios ◽  
Hypotonic Fluids ◽  
Hospital Acquired ◽  
The Impact

Background: Hyponatraemia is associated with increased morbidity, increased mortality and is frequently hospital-acquired due to inappropriate administration of hypotonic fluids. Despite several attempts to minimise the risk, knowledge is lacking as to whether inappropriate prescribing practice continues to be a concern. Methods: A cross-sectional survey was performed in Danish emergency department physicians in spring 2019. Prescribing practices were assessed by means of four clinical scenarios commonly encountered in the emergency department. Thirteen multiple-choice questions were used to measure knowledge. Results: 201 physicians responded corresponding to 55.4% of the total population of physicians working at emergency departments in Denmark. About a quarter reported that they would use hypotonic fluids in patients with increased intracranial pressure and 29.4% would use hypotonic maintenance fluids in children, both of which are against guideline recommendations. Also, 29.4% selected the correct fluid, a 3% hypertonic saline solution, for a patient with hyponatraemia and severe neurological symptoms, which is a medical emergency. Most physicians were unaware of the impact of hypotonic fluids on plasma sodium in acutely ill patients. Conclusion: Inappropriate prescribing practices and limited knowledge of a large number of physicians calls for further interventions to minimise the risk of hospital-acquired hyponatraemia.

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