scholarly journals A study on perception of clinicians regarding use of electronic medical record for patients attending outpatient departments in a tertiary care teaching hospital in northern India

2020 ◽  
Vol 8 (1) ◽  
pp. 237
Author(s):  
Samarpita Dutta ◽  
Nirupam Madaam ◽  
Parmeshwar Kumar
Keyword(s):  
Quality Of Care ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Tertiary Care ◽  
Background Information ◽  
Care Hospital ◽  
Outpatient Departments ◽  
Computer Based ◽  
The Mean

Background: Information technology is increasingly being recognized as an important tool for improving patient safety and quality of care. Use of electronic medical record has the greatest potential for improving quality in healthcare. Use of technology in a highly interactive environment such as the OPD has to be user friendly and acceptable. Therefore a study was carried out to assess the perception of clinicians regarding use of computer modules in clinical care in the outpatient departments of a tertiary care hospital in northern India.Methods: A cross sectional study was carried out over a period of two months in which 70 clinicians in the selected hospital were administered pre-designed questionnaire format for self reporting. It required them to rate their preferences regarding adoption of a computer based module for their OPDs and how this would affect their time and quality of patient care.Results: For a given computer based module in OPD, 81.4% of the clinicians supported its adoption. The mean scores suggested that most clinicians perceive that use of electronic medical record would improve quality of care. The mean scores for any of the parameters did not differ significantly amongst supporters and non-supporters of adoption of the module except on one parameter that it would be easier to follow a patient seen earlier by another clinician (p<0.05).Conclusions: Although there might be an initial resistance to change, overall clinicians perceive that introduction of electronic medical records on outpatient department would lead to improved quality of medical information management.

scholarly journals Cancellation of Elective Surgeries in A Tertiary Care Hospital in North India

2021 ◽  
Author(s):  
Nyla Farooq ◽  
Tauyiba Farooq Mir
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
North India ◽  
Care Hospital ◽  
Cancellation Rate ◽  
Surgical Treatments ◽  
Operational Time

Background: Cancellation of elective surgical treatments is a quality-of-care issue as well as a huge waste of health-care resources. Patients may experience emotional distress as a result of this, as well as difficulty for their families. Aim: To find the significant reasons of cancellation of scheduled surgical cases. Methods: A total of 300 elective operations in our institution were chosen. The completed surgeries were planned on the scheduled operation day, and the anaesthesiologist noted down a list of cancellations along with their reasons. Results: A total of 300 patients were scheduled for surgery. A total of 60 patients were cancelled, resulting in a 20% cancellation rate. Lack of operational time was the most prevalent reason for cancellation. Conclusion: The majority of the reasons for cancellation should have been avoided with proper list preparation and the surgical team's meticulous planning.

scholarly journals Integrating Patient-Generated Health Data in an Electronic Medical Record: Stakeholders’ Perspectives

2020 ◽  
Author(s):  
Katherine Blondon ◽  
Frederic Ehrler
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Focus Group ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Health Data ◽  
Improve Quality

Patient-generated health data (PGHD), when shared with the provider, provides potential as an approach to improve quality of care. Based on interviews and a focus group with stakeholders involved in PGHD integration in the electronic medical record (EMR), we explore the benefits, barriers and possible risks. We propose solutions to address liability concerns, such as clarifying patient and provider expectations for the analyses of PGHD and emphasize considerations for future steps, which include the need to screen PGHD for patient safety.

scholarly journals #27: Comparison of RT-PCR Cycle Threshold Values from Respiratory Specimens in Symptomatic and Asymptomatic Children with SARS CoV-2 Infection

2021 ◽  
Vol 10 (Supplement_2) ◽  
pp. S10-S11
Author(s):  
John Strutner ◽  
Nanda Ramchandar ◽  
Shruti Dubey ◽  
Mary Gamboa ◽  
Michelle K Vanderpool ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Tertiary Care ◽  
Severe Illness ◽  
Rt Pcr ◽  
Respiratory Specimen ◽  
Cycle Threshold ◽  
Ct Value ◽  
Asymptomatic Children ◽  
The Mean

Abstract Background Understanding viral kinetics of SARS-CoV-2 is important to assess risk of transmission, manage treatment, and determine the need for isolation and protective equipment. Children have been noted to have less severe illness than adults and may have less transmission potential. We sought to determine whether children deemed to be asymptomatic had a difference in the PCR cycle threshold (Ct) value of respiratory samples from symptomatic children with SARS CoV-2 infection. Methods This was a retrospective cross-sectional study to compare PCR Ct values of 728 children who tested positive for SARS-CoV-2 by respiratory samples collected over a 4-month period. The study was a single center review of patients who tested positive for SARS-CoV-2 by RT-PCR from a respiratory specimen at a large tertiary care children’s hospital. Inclusion criteria included children 0–18 years of age who tested positive for SARS-CoV-2 by RT-PCR from a respiratory specimen for whom clinical information was available in the electronic medical record. Results We analyzed 728 children who tested positive for SARS-CoV-2 by RT-PCR from a respiratory sample over a 4-month period and for whom data was available in the electronic medical record. Overall, 71.2% of infected children were symptomatic. The mean Ct value for symptomatic patients (Ct mean 19.9, SD 6.3) was significantly lower than asymptomatic patients (Ct mean 23.5, SD 6.5) (P value &lt; 0.001, CI95th 2.6 - 4.6). The mean PCR Ct value was lowest in children less than 5 years of age. Conclusions and Relevance In this retrospective review of children who tested positive by RT-PCR for SARS CoV-2, the mean Ct was significantly lower in symptomatic children and was lowest in children under 5 years of age.

scholarly journals Quality of care for peripheral intravenous catheters (PIVCs) in Nepal: a cross-sectional study on feasibility and inter-rater agreement of the Peripheral Intravenous Catheters-mini Questionnaire (PIVC-miniQ) in a tertiary care hospital

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e048370
Author(s):  
Sulekha Shrestha ◽  
Johannes Vieler ◽  
Nikolai Juliussen Haug ◽  
Jan Egil Afset ◽  
Lise Husby Høvik ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Secondary Outcome ◽  
Care Hospital ◽  
Rater Agreement ◽  
Cross Sectional ◽  
Sum Score ◽  
Intravenous Catheters

ObjectivesThere is a lack of data regarding the quality of peripheral intravenous catheter (PIVC)-related care from low-income and middle-income countries, even though the use of PIVCs may lead to local or severe systemic infections. Our main objective was to assess the feasibility and inter-rater agreement on the PIVC-mini Questionnaire (PIVC-miniQ) in a tertiary care hospital in Nepal.DesignWe performed an observational cross-sectional quantitative study using the PIVC-miniQ to collect information on PIVC quality.SettingSecondary care in a Nepalese hospital. All patients with PIVCs in selected wards were included in the study and PIVCs were assessed independently by two raters. Eight Nepalese nurses, one Nepalese student and three Norwegian students participated as raters.Primary and secondary outcome measuresThe intraclass correlation coefficient (ICC), positive, negative, absolute agreement, Scott’s pi and sum score were calculated using PIVC-miniQ. We also aimed to describe PIVC quality of care, as it is important to prevent PIVC-associated complications such as phlebitis or catheter-associated bloodstream infections.ResultsA total of 390 patients (409 PIVCs) were included in the study. The ICC between raters was 0.716 for Nepalese raters, 0.644 for Norwegian raters and 0.481 for the pooled data. The most frequently observed problems associated with PIVCs were blood in the intravenous line (51.5%), pain and tenderness on palpation (43.4%), and fixation with opaque tape (38.5%). The average sum score was 3.32 deviations from best practice for PIVCs fixed with non-sterile opaque tape and 2.37 for those fixed with transparent dressing (p<0.001).ConclusionThe PIVC-miniQ is a feasible and reliable tool for nurses assessing PIVC quality in hospitalised patients in Nepal. The study revealed gaps in PIVC quality and care that could be improved by providing transparent PIVC dressings for all patients and requiring all PIVC insertions to be documented in patient charts.

scholarly journals Sex-differences in determinants of suicide risk preceding psychiatric admission: An electronic medical record study

2020 ◽  
Author(s):  
Robyn J. McQuaid ◽  
Katerina Nikolitch ◽  
Katie L. Vandeloo ◽  
Patricia Burhunduli ◽  
Jennifer L. Phillips
Keyword(s):  
Risk Factors ◽  
Sex Differences ◽  
Hospital Admission ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Tertiary Care ◽  
Assessment Instrument ◽  
Care Hospital ◽  
Psychiatric Admission ◽  
Suicide Plan

ABSTRACTUsing electronic medical record (EMR) data collected from psychiatric inpatient admissions, the objective of this study was to identify sex differences in risk factors for presence of suicide plans and/or attempts within the 30 days preceding hospital admission. Resident Assessment Instrument for Mental Health (RAI-MH) intake data were obtained for patients admitted to a Canadian tertiary-care hospital deemed a ‘threat or danger to self’ during a ten-year period (2008-2018). Data was extracted for individuals categorized into three groups: non-suicidal (N=568), presence of suicide plan (N=178), and presence of suspected suicide attempt (N=124) in the 30 days prior to hospital admission. A multivariate logistic regression revealed that younger age (odds ratio=0.97), female sex (OR=1.56), disrupted family relationships (OR=1.54), recent stressors (OR=1.59), participation in social activities (OR=1.54), having no confidant (OR=1.55), and diagnosis of depressive disorder (OR=5.54) increased the odds of suicide plan and/or attempt in the 30 days prior to hospital admission. Stratifying the regression model by sex highlighted different risk factors for suicide plan and attempt specific to males and females. EMR-derived findings highlight psychosocial and clinical determinants associated with suicide plan or attempt prior to psychiatric admission that differ according to sex.

scholarly journals A case series of cyclic vomiting syndrome in paediatric patients at a tertiary care hospital in Chennai, Tamil Nadu, India

2018 ◽  
Vol 6 (1) ◽  
pp. 118
Author(s):  
Ruchi R. Mittal ◽  
Latha Ravichandran ◽  
Elayaraja Elayaraja
Keyword(s):  
Tamil Nadu ◽  
Tertiary Care ◽  
Case Series ◽  
Cyclic Vomiting Syndrome ◽  
Care Hospital ◽  
Severe Nausea ◽  
Paediatric Patients ◽  
The Mean ◽  
Cyclic Vomiting

Background: Cyclic vomiting syndrome is an increasingly recognized disorder with sudden, repeated episodes of severe nausea, vomiting, and physical exhaustion that occur with no apparent cause. It is more common in children than adults. However, we don’t often see a diagnosis of cyclic vomiting syndrome being made. Hereby we report 7 cases of cyclical vomiting.Methods: This is a retrospective study. Medical records of 5 years were review and consecutive paediatric patients discharged with a diagnosis of cyclic vomiting syndrome were identified, data collected and analysed.Results: Total of 7 cases were found, all of which were adolescents. The mean age was 13.28. 57.14% (4) were females and 42.86% (3) were boys. 42.86% (3) presented with complications. 14.28% (1) had an association with menstrual cycles and 14.28% (1) had an association with psychological stress.Conclusions: Cyclic vomiting syndrome should be kept in mind when a child presents with multiple episodes of vomiting, especially when repeated admissions have been made for the same. Early diagnosis and treatment can improve the quality of life.

scholarly journals Surgery at the End of Life

2013 ◽  
Vol 119 (4) ◽  
pp. 796-801 ◽  
Author(s):  
Caryn S. Barnet ◽  
Alexander F. Arriaga ◽  
David L. Hepner ◽  
Darin J. Correll ◽  
Atul A. Gawande ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Preoperative Assessment ◽  
Patient Characteristics ◽  
Care Hospital ◽  
Medicare Beneficiaries ◽  
Care Providers ◽  
Elective Procedure

Abstract Background: More than a quarter of medical costs for Medicare beneficiaries are incurred in the last year of life; surgical intensity during this time is significant. This study was performed to determine types of operations patients undergo in their terminal year, and compare characteristics of decedents with those of survivors. Methods: Population of 747 consecutive all-payer patients seen at the preoperative assessment center of a tertiary care hospital. Patient characteristics were obtained from the electronic medical record. Surgical indication (palliative, curative, diagnostic, elective) was assessed based on procedure performed and underlying diagnosis. Vital status was determined using the electronic medical record with confirmation via social security national death master file. Descriptive statistics were performed to compare patient characteristics and procedures performed on those who died within 1 yr of procedure with those of survivors. Results: Thirty-seven patients (5%) were confirmed dead at 1 yr. Ten (27%) of these had palliative procedures, 11 (30%) diagnostic, 14 (38%) curative, and 2 (5%) elective. Decedents were more likely to have undergone a palliative (27 vs. 3%) or diagnostic (30 vs. 14%) procedure and less likely to have undergone an elective procedure (5 vs. 42%) than survivors (P &lt; 0.0001). Nearly half of decedents did not have an advanced directive by the date of surgical intervention. Conclusions: Nearly 1 in 20 patients seen at the preoperative assessment clinic of a tertiary care hospital died within 1 yr of their procedure. Patient characteristics and procedure indication for decedents differed from those of survivors. Similar analyses based on institution and region may provide methodologies to compare variation in surgical intensity and assist preoperative care providers in evaluating appropriateness of resource allocation.

End-of-life symptoms and interventions among women with gynecologic cancers in a tertiary-care hospital in Thailand

2019 ◽  
Vol 29 (5) ◽  
pp. 951-955
Author(s):  
Thanchanok Sompratthana ◽  
Natacha Phoolcharoen ◽  
Kathleen M Schmeler ◽  
Ruangsak Lertkhachonsuk
Keyword(s):  
Quality Of Life ◽  
End Of Life ◽  
Medical Records ◽  
Uterine Cancer ◽  
Tertiary Care ◽  
Care Hospital ◽  
Do Not Resuscitate ◽  
Gynecologic Cancers ◽  
The Mean

ObjectivesStudies have shown improved patient quality of life with supportive care rather than aggressive treatment at the end of life. This study evaluated the symptoms that patients in Thailand with gynecologic cancers experienced and the interventions that they received at the end of life.MethodsThe medical records of patients admitted to a tertiary cancer center in Thailand who died in the hospital from gynecologic malignancies between January 1, 2011 and December 31, 2016 were reviewed. Inclusion criteria were patients who had been been diagnosed with gynecologic cancers (ovarian, endometrial, cervical, vulvar, or peritoneal cancers or uterine sarcomas) and had died in the hospital during that period. Patients whose medical records were incomplete or unavailable were excluded from the study. Data on demographics, symptoms, interventions, and end-of-life care were collected.ResultsA total of 159 patients were included in this analysis. The mean age at death was 54.3 (range 15–91) years. Over half (54.7%) of the patients were diagnosed with ovarian or peritoneal cancer, 26.4% with uterine cancer or sarcoma, 16.4% with cervical cancer, and 1.3% with dual primary cancers. Symptoms at time of admission were poor oral intake (68.6%), abdominal distention or discomfort (63.5%), pain (42.8%), nausea or vomiting (35.2%), and fever or signs of infection (27.0%). The mean number of hospitalizations during the last 6 months was 3.6. Thirty-six patients (22.6%) had major surgery during the last 6 months of life, with 14 patients (8.8%) having it performed during their last admission before death. The mean length of the last hospital stay was 22.3 (range 6–31) days, and 61 patients (38.4%) were admitted to the intensive care unit. Eleven patients (6.9%) had chemotherapy in their last 14 days of life and 10 (6.3%) received cardiopulmonary resuscitation. Almost all patients (153, 96.2%) had do-not-resuscitate (DNR) consents. The mean time between the DNR consent and death was 6.3±9.7 days.ConclusionMultiple hospital admissions, aggressive treatments, and invasive procedures were common among patients with gynecologic cancer at the end of life. Better symptom management, end-of-life preparation, and communication are needed to enhance patients’ quality of life in Thailand.

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