scholarly journals Process and outcome of management for orthopedic patients with sepsis

2021 ◽  
Vol 60 (2) ◽  
Author(s):  
P Insook ◽  
◽  
S Wangsrikhun ◽  
A Sukonthasarn ◽  
◽  
...  
Keyword(s):  
Fluid Resuscitation ◽  
Medical Records ◽  
Serum Lactate ◽  
Antibiotic Administration ◽  
Management Process ◽  
Lactate Measurement ◽  
Process And Outcome ◽  
Orthopedic Patients ◽  
Overall Mortality

Objectives To analyze the management process and outcomes of orthopedic patients diagnosed with sepsis. Methods This retrospective descriptive study included the medical records 275 orthopedics patients with sepsis from January 2017 to December 2019. Data collection was done using the Management Situation for Orthopedic Patients with Sepsis Record Form. Descriptive statistics were used for data analysis. Results Within 3 hours after being diagnosed with sepsis, the following management process occurred: 82.90% of the samples had blood collected for culturing before antibiotic administration, 31.27% received broad-spectrum antibiotics, 15.63% had serum lactate measurement and the 50.00% of the patients requiring fluid resuscitation (n=56) received initial fluid resuscitation. Within 6 hours following diagnosis, the 32.07% of the sample requiring vasopressors (n=53) received them. Of the patients in the study, 13.18% developed septic shock and the overall mortality rate was 18.19% (n=50). Conclusions There are opportunities for improvement of the management process for orthopedic patients with sepsis. Improvements in the quality of the management process could lead to better outcomes.

scholarly journals Widespread gaps in the quality of care for primary biliary cholangitis in UK

2021 ◽  
pp. flgastro-2020-101713
Author(s):  
Mathuri Sivakumar ◽  
Akash Gandhi ◽  
Eathar Shakweh ◽  
Yu Meng Li ◽  
Niloufar Safinia ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Medical Records ◽  
Clinical Symptoms ◽  
Primary Biliary Cholangitis ◽  
Cholestatic Liver Disease ◽  
Patient Demographics ◽  
Risk Patients ◽  
Wide Scale ◽  
The Uk

ObjectivePrimary biliary cholangitis (PBC) is a progressive, autoimmune, cholestatic liver disease affecting approximately 15 000 individuals in the UK. Updated guidelines for the management of PBC were published by The European Association for the Study of the Liver (EASL) in 2017. We report on the first national, pilot audit that assesses the quality of care and adherence to guidelines.DesignData were collected from 11 National Health Service hospitals in England, Wales and Scotland between 2017 and 2020. Data on patient demographics, ursodeoxycholic acid (UDCA) dosing and key guideline recommendations were captured from medical records. Results from each hospital were evaluated for target achievement and underwent χ2 analysis for variation in performance between trusts.Results790 patients’ medical records were reviewed. The data demonstrated that the majority of hospitals did not meet all of the recommended EASL standards. Standards with the lowest likelihood of being met were identified as optimal UDCA dosing, assessment of bone density and assessment of clinical symptoms (pruritus and fatigue). Significant variations in meeting these three standards were observed across UK, in addition to assessment of biochemical response to UDCA (all p<0.0001) and assessment of transplant eligibility in high-risk patients (p=0.0297).ConclusionOur findings identify a broad-based deficiency in ‘real-world’ PBC care, suggesting the need for an intervention to improve guideline adherence, ultimately improving patient outcomes. We developed the PBC Review tool and recommend its incorporation into clinical practice. As the first audit of its kind, it will be used to inform a future wide-scale reaudit.

The relationship between patient donation and satisfaction with online healthcare service quality

2019 ◽  
Vol 47 (12) ◽  
pp. 1-10
Author(s):  
Yuanrong Hu ◽  
Shengkang Lu ◽  
Zhongming Tang
Keyword(s):  
Patient Satisfaction ◽  
Healthcare Service ◽  
Outcome Quality ◽  
Healthcare Applications ◽  
Mobile Healthcare ◽  
Process And Outcome ◽  
Patient Consultation ◽  
The Impact ◽  
The Relationship

We explored how donation relates to patient satisfaction with the quality of process and outcome in an online healthcare service. Using a dataset of 496,723 patient consultation records collected from ChunyuDoctor, which is among the largest of the Chinese mobile healthcare applications, we conducted a multiple regression and found that patient satisfaction with both process and outcome jointly influenced their donation. We also found that higher quality satisfaction levels meant paying patients were more likely to donate than were free patients. Our results also showed satisfaction with the quality of the process and the outcome had an equal impact on patient donation for the free patients, but the impact of process quality was greater than that of outcome quality for the paying patients, suggesting the importance of enhancing the quality of the process in an online healthcare service. Implications of the findings are discussed.

Research Note: Women's Experience of the Mother Role

1993 ◽  
Vol 41 (2) ◽  
pp. 347-360 ◽  
Author(s):  
Pat O'Connor
Keyword(s):  
Medical Records ◽  
Rating Scales ◽  
Empirical Work ◽  
Research Note ◽  
Small Scale ◽  
Intensive Study ◽  
Lower Middle Class ◽  
Women's Experience ◽  
Mother Role

Despite the feminist critique of the assumptions implicit in the ideology of motherhood, relatively little empirical work has been done on women's own experience of this role. This research note uses data from a small scale intensive study of 51 married or cohabiting mothers aged 20–42 years old, whose oldest child was 15 years old, and who were randomly selected from medical records in a lower middle class area of North London. Building on Boulton's (1983) conceptualization, it differentiates between three aspects of this role (namely their commitment to it; its perceived identity enhancing/ destructive character and the positive/negative quality of their interaction with their children). These women's experience of the mother role was then assessed on these dimensions – using rating scales and anchoring examples (which are illustrated here). This research note suggests that even within this relatively homogenous lower middle/upper working class sample, the experience of motherhood was extremely varied: with less than half of the sample experiencing it positively at all three levels. An attempt is made to explain this variation.

scholarly journals Benefit-risk of Patients' Online Access to their Medical Records: Consensus Exercise of an International Expert Group

2018 ◽  
Vol 27 (01) ◽  
pp. 156-162 ◽  
Author(s):  
Harshana Liyanage ◽  
Siaw-Teng Liaw ◽  
Emmanouela Konstantara ◽  
Freda Mold ◽  
Richard Schreiber ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Informatics ◽  
Medical Records ◽  
Panel Discussion ◽  
Care Quality ◽  
Care Providers ◽  
Consensus Statements ◽  
Online Access ◽  
The Impact

Background: Patients' access to their computerised medical records (CMRs) is a legal right in many countries. However, little is reported about the benefit-risk associated with patients' online access to their CMRs. Objective: To conduct a consensus exercise to assess the impact of patients' online access to their CMRs on the quality of care as defined in six domains by the Institute of Medicine (IoM), now the National Academy of Medicine (NAM). Method: A five-round Delphi study was conducted. Round One explored experts' (n = 37) viewpoints on providing patients with access to their CMRs. Round Two rated the appropriateness of statements arising from Round One (n = 16). The third round was an online panel discussion of findings (n = 13) with the members of both the International Medical Informatics Association and the European Federation of Medical Informatics Primary Health Care Informatics Working Groups. Two additional rounds, a survey of the revised consensus statements and an online workshop, were carried out to further refine consensus statements. Results: Thirty-seven responses from Round One were used as a basis to initially develop 15 statements which were categorised using IoM's domains of care quality. The experts agreed that providing patients online access to their CMRs for bookings, results, and prescriptions increased efficiency and improved the quality of medical records. Experts also anticipated that patients would proactively use their online access to share data with different health care providers, including emergencies. However, experts differed on whether access to limited or summary data was more useful to patients than accessing their complete records. They thought online access would change recording practice, but they were unclear about the benefit-risk of high and onerous levels of security. The 5-round process, finally, produced 16 consensus statements. Conclusion: Patients' online access to their CMRs should be part of all CMR systems. It improves the process of health care, but further evidence is required about outcomes. Online access improves efficiency of bookings and other services. However, there is scope to improve many of the processes of care it purports to support, particularly the provision of a more effective interface and the protection of the vulnerable.

scholarly journals Improving Information management in resource as a service framework using gamification technique: a case study in Institut Pendidikan Guru Malaysia

2018 ◽  
Vol 7 (2.14) ◽  
pp. 70
Author(s):  
M Nordin A Rahman ◽  
WM Khairi ◽  
W Awang
Keyword(s):  
Competitive Advantage ◽  
Information Management ◽  
Teaching And Learning ◽  
Storage Management ◽  
Quality Of Services ◽  
Management Process ◽  
Different Types ◽  
Service Framework

The issue of information management is crucial for any academic institution. Convenient access to requested content is creating a competitive advantage for different types of decisions. Information management process in Institut Pendidikan Guru (IPG) often create problems because there is no systematic way of storage management. IPG lecturers stored their teaching materials in different kind of methods. This situation cause in a loss of resources, difficult to retrieve and also cannot be identified when it's needed. Dealing with large volumes of resources it is essential to use technological solutions that enable flexible storage, retrieval, processing and interpreting information. To solve the problems, this article introduced a framework that use single platform and named as Information Sharing for Learning (IS4L) for managing teaching and learning resources in IPG. The resources will be stored and can be accessed at any time. The framework also applied the technique of gamification to motivate and encourage users to use the application and consequently will increase the volume of resources stored. The developed application based on the proposed framework could help to motivate and engage peoples to share their resources and enhance quality of services in IPG. Finally it could assist to improve the performance and effectiveness of services to achieve users’ satisfaction. 

scholarly journals PROFILE OF PATIENTS RECEIVING TOTAL KNEE ARTHROPLASTY: A CROSS-SECTIONAL STUDY

2017 ◽  
Vol 25 (5) ◽  
pp. 202-205 ◽  
Author(s):  
MARCELO JOSÉ CORTEZ BEZERRA ◽  
IGOR MAGALHÃES BARBOSA ◽  
THALES GONÇALVES DE SOUSA ◽  
LARISSA MEIRELES FERNANDES ◽  
DIEGO LEONARDO MENEZES MAIA ◽  
...  
Keyword(s):  
Medical Records ◽  
Severe Disease ◽  
Functional Limitation ◽  
Cross Sectional Study ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Lequesne Index ◽  
Total Knee ◽  
Epidemiological Profile

ABSTRACT Objective: To describe the epidemiological profile, presented deformities, associated comorbidities, and impact on quality of life in patients with knee osteoarthritis. This study was conducted in a philanthropic hospital in Fortaleza from 2014 to 2015. Methods: Data were collected from medical records, epidemiological forms, and by applying the Lequesne index questionnaire, which contains several questions related to pain, discomfort and functional limitation to assess the severity of symptoms. Results: Females were more prevalent (76.7%), as were patients over 65 years of age (61.6%) and non-whites (81.6%). As for comorbidities, 83.3% had hypertension and 31.7% had diabetes. Of the total, 76.5% cases were genu varum, and 23.5% genu valgum. According to the Lequesne index findings, 61.6% cases were “extremely severe,” and women had higher scores. Conclusion: Females were more prevalent and whites were less prevalent. The most frequent comorbidity was hypertension. Female and elderly patients have more severe disease according to Lequesne index score, and these findings were statistically significant. Level of Evidence II, Prospective Study.

scholarly journals Improving Nursing Care Documentation in Emergency Department: A Participatory Action Research Study in Iran

2018 ◽  
Vol 6 (8) ◽  
pp. 1527-1532 ◽  
Author(s):  
Seyed Majid Vafaei ◽  
Zahra Sadat Manzari ◽  
Abbas Heydari ◽  
Razieh Froutan ◽  
Leila Amiri Farahani
Keyword(s):  
Emergency Department ◽  
Action Research ◽  
Nursing Care ◽  
Medical Records ◽  
Research Study ◽  
Collaborative Action Research ◽  
Second Phase ◽  
Monitoring And Control ◽  
Action Research Study

BACKGROUND: Standardization of documentation has enabled the use of medical records as a primary tool for evaluating health care functions and obtaining appropriate credit points for medical centres. However, previous studies have shown that the quality of medical records in emergency departments is unsatisfactory.AIM: The aim of this study was improving the nursing care documentation in an emergency department, in Iran.MATERIAL AND METHODS: This collaborative action research study was carried out in two phases to improve nursing care documentation in cooperation with individuals involved in the process, from February 2015 to December 2017 in an affiliated academic hospital in Iran. The first phase featured virtual training, an educational workshop, and improvements to the hospital information system. The second phase involved the recruitment of human resources, the implementation of continuous codified training, the establishment of an appropriate reward and penalty system, and the review of patient education forms.RESULTS: The interventions improved nursing documentation quality score of 73.20%, which was the highest accreditation ranking provided by Iran’s Ministry of Health and Medical Education in 2017. In other words, this study caused a 32% improvement in the quality of nursing care documentation in the hospital.CONCLUSION: The appropriate practices for improving nursing care documentation are employee participation, managerial accountability, nurses’ adherence to documentation standards, improved leadership style, and continuous monitoring and control.

scholarly journals Identification of post-cesarean surgical site infection: nursing consultation

2018 ◽  
Vol 71 (suppl 3) ◽  
pp. 1395-1403
Author(s):  
Marcia Regina Cunha ◽  
Maria Clara Padoveze ◽  
Célia Regina Maganha e Melo ◽  
Lucia Yasuko Izumi Nichiata
Keyword(s):  
Quality Of Service ◽  
Health Status ◽  
Surgical Site Infection ◽  
Medical Records ◽  
Signs And Symptoms ◽  
Site Infection ◽  
Cross Sectional ◽  
Cesarean Deliveries ◽  
The City

ABSTRACT Objective: To describe the profile of women in relation to their living conditions, health status and socio-demographic profile, correlating it with the presence of signs and symptoms suggestive of post-cesarean surgical site infection, identifying information to be considered in the puerperium consultation performed by nurses and proposing a roadmap for the systematization of care. Method: Quantitative, exploratory, descriptive, cross-sectional and retrospective review of medical records of women who had cesarean deliveries in 2014, in the city of São Paulo. Results: 89 medical records were analyzed, 62 of them with incomplete information. In 11, there was at least one of the signs and symptoms suggestive of infection. Conclusion: Given the results of the study, the systematization of puerperal consultation is essential. The roadmap is an instrument that can potentially improve the quality of service and the recording of information.

scholarly journals Reliability of medical audit in quality assessment of medical care

1996 ◽  
Vol 12 (suppl 2) ◽  
pp. S85-S93 ◽  
Author(s):  
Luiz Antonio Bastos Camacho ◽  
Haya Rahel Rubin
Keyword(s):  
Quality Assessment ◽  
Interrater Agreement ◽  
Medical Audit ◽  
Hospital Physician ◽  
Hospital Records ◽  
Care Assessment ◽  
Process And Outcome ◽  
Physician Judgment ◽  
Current Stage

Medical audit of hospital records has been a major component of quality of care assessment, although physician judgment is known to have low reliability. We estimated interrater agreement of quality assessment in a sample of patients with cardiac conditions admitted to an American teaching hospital. Physician-reviewers used structured review methods designed to improve quality assessment based on judgment. Chance-corrected agreement for the items considered more relevant to process and outcome of care ranged from low to moderate (0.2 to 0.6), depending on the review item and the principal diagnoses and procedures the patients underwent. Results from several studies seem to converge on this point. Comparisons among different settings should be made with caution, given the sensitivity of agreement measurements to prevalence rates. Reliability of review methods in their current stage could be improved by combining the assessment of two or more reviewers, and by emphasizing outcome-oriented events.

Sign in / Sign up

Export Citation Format

Share Document