scholarly journals Clinical decision-making approaches by health caregivers of patients with COVID-19

2020 ◽  
Vol 7 (10) ◽  
pp. 4056-4057
Author(s):  
Mohsen Taghadosi ◽  
Neda Mirbagher Ajorpaz ◽  
Mohammad Aghajani
Keyword(s):  
Decision Making ◽  
Health Care Providers ◽  
Clinical Decision Making ◽  
Quality Care ◽  
Healthcare Providers ◽  
Clinical Decision ◽  
World Health ◽  
Care Providers ◽  
Health Crisis ◽  
The World

The Coronavirus disease of 2019 COVID-19) is the current health crisis in the world- a new, complex phenomenon that has affected and hospitalized many people around the world. Health care providers deal with COVID-19 patients daily and care for the patients while there is no definitive cure for it. Clinical decision-making is an important task of health professionals that plays an essential role in preserving the patient's life and providing quality care. Therefore, understanding clinical decision-making approaches by healthcare providers, such as nurses and physicians, especially in crises such as COVID-19, is essential.

mHealth in clinical decision-making: A systematic literature review (Preprint)

2019 ◽  
Author(s):  
Amandeep Dhir
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Providers ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Future Research ◽  
Care Providers ◽  
Rigorous Approach ◽  
Almost All ◽  
Mhealth Apps

UNSTRUCTURED A large number of mHealth apps are available nowadays for patients and health care providers. Many of those apps are designed specifically for clinical decision making (CDM). Despite their proliferation, limited studies have examined the utilization and effectiveness of these apps. The current study undertakes a systematic review to organize and synthesize the extant literature on mHealth for CDM in all resource settings. A thorough search of databases resulted in a preliminary list of 1,313 titles and abstracts, of which 1,107 were excluded as they were either duplicates or irrelevant to the scope of the study. Thereafter, full-text screening of the remaining 206 articles was performed, and 175 were excluded on the basis of pre-specified inclusion/exclusion criteria. This rigorous approach resulted in the identification of 31 studies for inclusion in the review. The utilization of mHealth for CDM appears to have pervaded almost all health care settings, as demonstrated by the insights gleaned from the review of the prior studies in the domain. However, the evidence of effectiveness is still limited and unreliable, which underscores the existence of a paucity of accumulated knowledge that, in turn, invites interesting opportunities for future research.

scholarly journals MORE ENABLING APPROACH: A CHALLENGE FOR THE PRACTITIONERS- A CRITICAL REVIEW

2016 ◽  
Vol 5 (1) ◽  
pp. 4-10
Author(s):  
Amna Aamir Khan ◽  
Sumaira Imran Farooqui
Keyword(s):  
Decision Making ◽  
Health Care Providers ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Activity Limitation ◽  
Multidisciplinary Teams ◽  
Evidence Based ◽  
Care Providers ◽  
Participation Restriction

The multidisciplinary teams of today are working in-collaboration and as one unit to assess, set goals, evaluate and provide reliable interventions to the patients/client. The essence of conceptual framework of ICF provides an opportunity to achieve the common goals of activity limitation and participation restriction by adapting a holistic model of rehabilitation encompassing the psychological, physical and the emotional needs with the advent of new techniques and modernized technologies. The new enabling approach is challenge faced by the health care providers where patient preferences, empowerment and health related quality of life are most essential. The review will provide a critical analysis on the barriers faced by the practitioner especially during clinical decision making. Psychosocial perspectives of the client that is the most ignored area is also emphasized in the review and also motivational aspects of the patients in promoting the evidence based practice and clinical decision making and ultimately focusing on the enablement of the disabled. KEYWORDS Enabling Approach, Evidence Based Practice, HRQoL, Clinical Decision Making, Psychological, Disability, Activity Limitation, Participation Restriction

Current Practices and Challenges of Medical Services on Health Care System of Mandalay General Hospital

2019 ◽  
Vol 31 (2) ◽  
pp. 131
Keyword(s):  
Health Care ◽  
General Hospital ◽  
Health Care Providers ◽  
Quality Care ◽  
Healthcare Providers ◽  
Medical Services ◽  
Tertiary Level ◽  
Care Providers ◽  
Level Hospital ◽  
Care System

In Myanmar, the main challenge to provide quality healthcare by Universal Health Care approach is documented as low health services coverage with substantial wealth-based inequality. To achieve the effective health care system, strong medical care system is essential. Understanding on challenges and needs in provision of medical services among patients and health care providers is critical to provide quality care with desirable outcomes. The aim of the study was to explore the patients’ and health care providers’ perceptions on the challenges in provision of medical services at the Mandalay General Hospital. This was a qualitative study conducted at the tertiary level hospital (Mandalay General Hospital). The data was collected by using focus group discussions and in-depth interviews with hospitalized patients or attendants, healthcare providers such as medical doctors, nurses, laboratory scientists and hospital administrators in March 2017. The qualitative data was analyzed using themes by themes matrix analysis. Most patients were satisfied with the care provided by the doctors because they believed that they received quality care. However, some patients complained about long waiting time for elective operation, congested conditions in the ward, burden for investigations outside the hospital for urgent needs and impolite manners of general workers. Healthcare providers reported that they had heavy workload due to limited human and financial resources in the hospital, poor compliances with hospital rules and regulation among patients and attendants, and inefficient referral practices from other health facilities. Other challenges experienced by healthcare providers were lack of ongoing training to improve knowledge and skills, limited health infrastructure and inadequate medicinal supplies. The findings highlighted the areas needed to be improved to provide quality health care at the tertiary level hospital. The challenges and problems encountered in this hospital can be improved by allocating adequate financial and human resources. The systematic referral system and hospital management guidelines are needed to reduce workload of health staff.

scholarly journals Ethical use of off-label disease-modifying therapies for multiple sclerosis

2021 ◽  
pp. 135245852110302
Author(s):  
Joanna Laurson-Doube ◽  
Nick Rijke ◽  
Anne Helme ◽  
Peer Baneke ◽  
Brenda Banwell ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
World Health ◽  
World Federation ◽  
Off Label ◽  
Disease Modifying Therapies ◽  
The World ◽  
Disease Modifying ◽  
Health Organization

Background: Off-label disease-modifying therapies (DMTs) for multiple sclerosis (MS) are used in at least 89 countries. There is a need for structured and transparent evidence-based guidelines to support clinical decision-making, pharmaceutical policies and reimbursement decisions for off-label DMTs. Objectives/Results: The authors put forward general principles for the ethical use of off-label DMTs for treating MS and a process to assess existing evidence and develop recommendations for their use. Conclusion: The principles and process are endorsed by the World Federation of Neurology (WFN), American Academy of Neurology (AAN), European Academy of Neurology (EAN), Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS), European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), Middle-East North Africa Committee for Treatment and Research in Multiple Sclerosis (MENACTRIMS) and Pan-Asian Committee for Treatment and Research in Multiple Sclerosis (PACTRIMS), and we have regularly consulted with the Brain Health Unit, Mental Health and Substance Use Department at the World Health Organization (WHO).

scholarly journals The development of the WHO Labour Care Guide: an international survey of maternity care providers

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Veronica Pingray ◽  
Mercedes Bonet ◽  
Mabel Berrueta ◽  
Agustina Mazzoni ◽  
María Belizán ◽  
...  
Keyword(s):  
Decision Making ◽  
Maternity Care ◽  
Health Personnel ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Research Network ◽  
Respectful Maternity Care ◽  
Care Providers ◽  
Skilled Health Personnel ◽  
Skilled Health

Abstract Background The partograph is the most commonly used labour monitoring tool in the world. However, it has been used incorrectly or inconsistently in many settings. In 2018, a WHO expert group reviewed and revised the design of the partograph in light of emerging evidence, and they developed the first version of the Labour Care Guide (LCG). The objective of this study was to explore opinions of skilled health personnel on the first version of the WHO Labour Care Guide. Methods Skilled health personnel (including obstetricians, midwives and general practitioners) of any gender from Africa, Asia, Europe and Latin America were identified through a large global research network. Country coordinators from the network invited 5 to 10 mid-level and senior skilled health personnel who had worked in labour wards anytime in the last 5 years. A self-administered, anonymous, structured, online questionnaire including closed and open-ended questions was designed to assess the clarity, relevance, appropriateness of the frequency of recording, and the completeness of the sections and variables on the LCG. Results A total of 110 participants from 23 countries completed the survey between December 2018 and January 2019. Variables included in the LCG were generally considered clear, relevant and to have been recorded at the appropriate frequency. Most sections of the LCG were considered complete. Participants agreed or strongly agreed with the overall design, structure of the LCG, and the usefulness of reference thresholds to trigger further assessment and actions. They also agreed that LCG could potentially have a positive impact on clinical decision-making and respectful maternity care. Participants disagreed with the value of some variables, including coping, urine, and neonatal status. Conclusions Future end-users of WHO Labour Care Guide considered the variables to be clear, relevant and appropriate, and, with minor improvements, to have the potential to positively impact clinical decision-making and respectful maternity care.

Risks of Cardiovascular Disease and Beyond in Prescription of Nonsteroidal Anti-Inflammatory Drugs

2019 ◽  
Vol 25 (1) ◽  
pp. 3-6 ◽  
Author(s):  
Manas A. Rane ◽  
Alexander Gitin ◽  
Benjamin Fiedler ◽  
Lawrence Fiedler ◽  
Charles H. Hennekens
Keyword(s):  
Cardiovascular Disease ◽  
Side Effects ◽  
Health Care Providers ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Care Providers ◽  
Relieve Pain ◽  
Gastrointestinal Side Effects ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Introduction: Nonsteroidal anti-inflammatory drugs (NSAIDs) include aspirin, naproxen, diclofenac, and ibuprofen, as well as selective cyclooxygenase 2 inhibitors such as celecoxib. Their use is common, as well as their side effects which cause 100 000 hospitalizations and 17 000 deaths annually. Recently, the US Food and Drug Administration strengthened its warning about the risks of cardiovascular disease (CVD) attributed to nonaspirin NSAIDs. Methods: When the sample size is large, randomization provides control of confounding not possible to achieve with any observational study. Further, observational studies and, especially, claims data have inherent confounding by indication larger than the small to moderate effects being sought. Results: While trials are necessary, they must be of sufficient size and duration and achieve high compliance and follow-up. Until then, clinicians should remain uncertain about benefits and risks of these drugs. Conclusions: Since the totality of evidence remains incomplete, health-care providers should consider all these aforementioned benefits and risks, both CVD and beyond, in deciding whether and, if so, which, NSAID to prescribe. The factors in the decision of whether and, if so, which NSAID to prescribe for relief of pain from inflammatory arthritis should not be limited to risks of CVD or gastrointestinal side effects but should also include potential benefits including improvements in overall quality of life resulting from decreases in pain or impairment from musculoskeletal pain syndromes. The judicious individual clinical decision-making about the prescription of NSAIDs to relieve pain based on all these considerations has the potential to do much more good than harm.

Consent, Refusal, and Waivers in Patient-Centered Dysphagia Care: Using Law, Ethics, and Evidence to Guide Clinical Practice

2016 ◽  
Vol 25 (4) ◽  
pp. 453-469 ◽  
Author(s):  
Jennifer Horner ◽  
Maria Modayil ◽  
Laura Roche Chapman ◽  
An Dinh
Keyword(s):  
Health Care ◽  
Public Policy ◽  
Clinical Practice ◽  
Health Care Providers ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Care Providers ◽  
Patient Centered ◽  
Legal Advice ◽  
Medical Context

PurposeWhen patients refuse medical or rehabilitation procedures, waivers of liability have been used to bar future lawsuits. The purpose of this tutorial is to review the myriad issues surrounding consent, refusal, and waivers. The larger goal is to invigorate clinical practice by providing clinicians with knowledge of ethics and law. This tutorial is for educational purposes only and does not constitute legal advice.MethodThe authors use a hypothetical case of a “noncompliant” individual under the care of an interdisciplinary neurorehabilitation team to illuminate the ethical and legal features of the patient–practitioner relationship; the elements of clinical decision-making capacity; the duty of disclosure and the right of informed consent or informed refusal; and the relationship among noncompliance, defensive practices, and iatrogenic harm. We explore the legal question of whether waivers of liability in the medical context are enforceable or unenforceable as a matter of public policy.ConclusionsSpeech-language pathologists, among other health care providers, have fiduciary and other ethical and legal obligations to patients. Because waivers try to shift liability for substandard care from health care providers to patients, courts usually find waivers of liability in the medical context unenforceable as a matter of public policy.

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