scholarly journals Competences of polish nurses in the field of prescribing medications: A systematic review

2021 ◽  
Vol 9 (6) ◽  
pp. 11-15
Author(s):  
Paulina Kasperska-Dębowska ◽  
Eliza Oleksy ◽  
Anna Wojtczak ◽  
Katarzyna Wojtysiak ◽  
Jakub Dreliszak ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Medical Devices ◽  
Personal Growth ◽  
Information Sources ◽  
High Quality ◽  
Nurse Prescribing ◽  
New Knowledge ◽  
Meta Analyses ◽  
Prescribing Medication

Purpose: The purpose of the following systematic review is to present polish regulations in terms of education, acquiring competencies in the field of prescribing drugs and medical devices. Methodology: The following review can be helpful to conduct comparative meta-analyses. Internet System of Legal Acts, PubMed, Google Scholar research was used to analyze the topic. The selected keywords were used to find information sources: law, competence, nurse, prescribing, medication, medical devices. Articles were selected according to regulations in Poland in terms of education, acquiring competencies in the field of prescribing drugs and medical devices. Main findings: The increase in nurses' competencies is equivalent to a greater need for knowledge and new knowledge acquired. Nurses take part not only in care and treatment, but also takes independent actions. In such enormous responsibilities, it is crucial to focus on the development of skills. Thus, a competent nurse is interested in continuous professional and personal growth and provides patients with high-quality nursing trustees. Implications of this study: The results should be considered in health care units, especially Primary Healthcare Units. The paper indicates the regulations in terms of education, acquiring competencies in the field of prescribing drugs which should be revised by personnel and implemented to improve the work of the healthcare unit. Novelty in this study: There is a lack of systematic reviews of the regulations in Poland in terms of education, acquiring competencies in the field of prescribing drugs and medical devices. The paper is an attempt to assess the topic.

scholarly journals Transforming the systematic review service: a team-based model to support the educational needs of researchers

2018 ◽  
Vol 106 (4) ◽  
Author(s):  
Stephanie Clare Roth
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Systematic Reviews ◽  
Educational Needs ◽  
Health Sciences ◽  
Educational Services ◽  
Educational Service ◽  
Service Model ◽  
High Quality ◽  
Health Care Settings

To meet the current needs of researchers who perform systematic reviews in health care settings, libraries need to provide high-quality educational services for researchers as part of their systematic review services. A team of librarians with diverse skills is also important for ensuring the growth and sustainability of systematic review services. This commentary describes a new team-based systematic review service model that can transform systematic review services by providing a pathway for librarians to offer a comprehensive educational service for systematic review research in a variety of health sciences library settings.

Medical visit time and predictors in health facilities: a mega systematic review and meta-analysis

2019 ◽  
Vol 12 (5) ◽  
pp. 373-402 ◽  
Author(s):  
Sakineh Hajebrahimi ◽  
Ali Janati ◽  
Morteza Arab-Zozani ◽  
Mobin Sokhanvar ◽  
Elaheh Haghgoshayie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Visit Time ◽  
Medical Visit ◽  
High Quality ◽  
Content Type ◽  
Face To Face ◽  
Significant Difference ◽  
Meta Analyses

Purpose Visit time is a crucial aspect of patient–physician interaction; its inadequacy can negatively impact the efficiency of treatment and diagnosis. In addition, visit time is a fundamental demand of patients, and it is one of the rights of every patient. The purpose of this paper is to determine factors influencing the consultation length of physicians and to compare consultation length in different countries. Design/methodology/approach MEDLINE (PubMed), Web of Science, Cochrane, ProQuest, Scopus, and Google Scholar were searched. In addition, references of references were checked, and publication lists of individual scholars in the field were examined. We used data sources up to June 2018, without language restriction. We used a random-effects model for the meta-analyses. Meta-analyses were conducted using Comprehensive Meta-Analysis Version (CMA) 3.0. Findings Of 16,911 identified studies, 189 studies were assessed of which 125 cases (67 percent) have been conducted in the USA. A total of 189 studies, 164 (86.77 percent) involved face-to face-consultations. The effects of three variables, physician gender, patient gender, and type of consultation were analyzed. According to moderate and strong evidence studies, no significant difference was found in the consultation lengths of female and male doctors (Q=42.72, df=8, I2=81.27, p=0.891) and patients’ gender (Q=55.98, df=11, I2=80.35, p=0.314). In addition, no significant difference was found in the telemedicine or face-to-face visits (Q=41.25, df=5, I2=87.88, p=0.170). Originality/value In this systematic review and meta-analysis, all of physicians’ visits in 34 countries were surveyed. The evidence suggests that specified variables do not influence the length of consultations. Good relationship is essential to a safe and high-quality consultation and referral process. A high-quality consultation can improve decisions and quality of visits, treatment effectiveness, efficiency of service, quality of care, patient safety and physician and patient satisfaction.

scholarly journals Predicting suicidal behaviours using clinical instruments: Systematic review and meta-analysis of positive predictive values for risk scales

2017 ◽  
Vol 210 (6) ◽  
pp. 387-395 ◽  
Author(s):  
Gregory Carter ◽  
Allison Milner ◽  
Katie McGill ◽  
Jane Pirkis ◽  
Nav Kapur ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Meta Analysis ◽  
Modifiable Risk Factors ◽  
High Quality ◽  
Policy Makers ◽  
Predictive Values ◽  
Effective Interventions ◽  
Self Harm ◽  
Meta Analyses

BackgroundPrediction of suicidal behaviour is an aspirational goal for clinicians and policy makers; with patients classified as ‘high risk’ to be preferentially allocated treatment. Clinical usefulness requires an adequate positive predictive value (PPV).AimsTo identify studies of predictive instruments and to calculate PPV estimates for suicidal behaviours.MethodA systematic review identified studies of predictive instruments. A series of meta-analyses produced pooled estimates of PPV for suicidal behaviours.ResultsFor all scales combined, the pooled PPVs were: suicide 5.5% (95% CI 3.9–7.9%), self-harm 26.3% (95% CI 21.8–31.3%) and self-harm plus suicide 35.9% (95% CI 25.8–47.4%). Subanalyses on self-harm found pooled PPVs of 16.1% (95% CI 11.3–22.3%) for high-quality studies, 32.5% (95% CI 26.1–39.6%) for hospital-treated self-harm and 26.8% (95% CI 19.5–35.6%) for psychiatric in-patients.ConclusionsNo ‘high-risk’ classification was clinically useful. Prevalence imposes a ceiling on PPV. Treatment should reduce exposure to modifiable risk factors and offer effective interventions for selected subpopulations and unselected clinical populations.

scholarly journals Patient Portals Facilitating Engagement With Inpatient Electronic Medical Records: A Systematic Review (Preprint)

2018 ◽  
Author(s):  
Ronald Dendere ◽  
Christine Slade ◽  
Andrew Burton-Jones ◽  
Clair Sullivan ◽  
Andrew Staib ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Outcomes ◽  
Electronic Medical Records ◽  
Patient Engagement ◽  
Medical Records ◽  
Provider Communication ◽  
Patient Portals ◽  
High Quality ◽  
Patient Provider Communication

BACKGROUND Engaging patients in the delivery of health care has the potential to improve health outcomes and patient satisfaction. Patient portals may enhance patient engagement by enabling patients to access their electronic medical records (EMRs) and facilitating secure patient-provider communication. OBJECTIVE The aim of this study was to review literature describing patient portals tethered to an EMR in inpatient settings, their role in patient engagement, and their impact on health care delivery in order to identify factors and best practices for successful implementation of this technology and areas that require further research. METHODS A systematic search for articles in the PubMed, CINAHL, and Embase databases was conducted using keywords associated with patient engagement, electronic health records, and patient portals and their respective subject headings in each database. Articles for inclusion were evaluated for quality using A Measurement Tool to Assess Systematic Reviews (AMSTAR) for systematic review articles and the Quality Assessment Tool for Studies with Diverse Designs for empirical studies. Included studies were categorized by their focus on input factors (eg, portal design), process factors (eg, portal use), and output factors (eg, benefits) and by the valence of their findings regarding patient portals (ie, positive, negative, or mixed). RESULTS The systematic search identified 58 articles for inclusion. The inputs category was addressed by 40 articles, while the processes and outputs categories were addressed by 36 and 46 articles, respectively: 47 articles addressed multiple themes across the three categories, and 11 addressed only a single theme. Nineteen articles had high- to very high-quality, 21 had medium quality, and 18 had low- to very low-quality. Findings in the inputs category showed wide-ranging portal designs; patients’ privacy concerns and lack of encouragement from providers were among portal adoption barriers while information access and patient-provider communication were among facilitators. Several methods were used to train portal users with varying success. In the processes category, sociodemographic characteristics and medical conditions of patients were predictors of portal use; some patients wanted unlimited access to their EMRs, personalized health education, and nonclinical information; and patients were keen to use portals for communicating with their health care teams. In the outputs category, some but not all studies found patient portals improved patient engagement; patients perceived some portal functions as inadequate but others as useful; patients and staff thought portals may improve patient care but could cause anxiety in some patients; and portals improved patient safety, adherence to medications, and patient-provider communication but had no impact on objective health outcomes. CONCLUSIONS While the evidence is currently immature, patient portals have demonstrated benefit by enabling the discovery of medical errors, improving adherence to medications, and providing patient-provider communication, etc. High-quality studies are needed to fully understand, improve, and evaluate their impact.

scholarly journals Artificial Intelligence-Aid Colonoscopy Vs. Conventional Colonoscopy for Polyp and Adenoma Detection: A Systematic Review of 7 Discordant Meta-Analyses

2022 ◽  
Vol 8 ◽  
Author(s):  
Hui Pan ◽  
Mingyan Cai ◽  
Qi Liao ◽  
Yong Jiang ◽  
Yige Liu ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Systematic Review ◽  
Systematic Reviews ◽  
Detection Rate ◽  
Conventional Colonoscopy ◽  
Cochrane Library ◽  
High Quality ◽  
Decision Algorithm ◽  
Adenoma Detection ◽  
Meta Analyses

Objectives: Multiple meta-analyses which investigated the comparative efficacy and safety of artificial intelligence (AI)-aid colonoscopy (AIC) vs. conventional colonoscopy (CC) in the detection of polyp and adenoma have been published. However, a definitive conclusion has not yet been generated. This systematic review selected from discordant meta-analyses to draw a definitive conclusion about whether AIC is better than CC for the detection of polyp and adenoma.Methods: We comprehensively searched potentially eligible literature in PubMed, Embase, Cochrane library, and China National Knowledgement Infrastructure (CNKI) databases from their inceptions until to April 2021. Assessment of Multiple Systematic Reviews (AMSTAR) instrument was used to assess the methodological quality. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was used to assess the reporting quality. Two investigators independently used the Jadad decision algorithm to select high-quality meta-analyses which summarized the best available evidence.Results: Seven meta-analyses met our selection criteria finally. AMSTAR score ranged from 8 to 10, and PRISMA score ranged from 23 to 26. According to the Jadad decision algorithm, two high-quality meta-analyses were selected. These two meta-analyses suggested that AIC was superior to CC for colonoscopy outcomes, especially for polyp detection rate (PDR) and adenoma detection rate (ADR).Conclusion: Based on the best available evidence, we conclude that AIC should be preferentially selected for the route screening of colorectal lesions because it has potential value of increasing the polyp and adenoma detection. However, the continued improvement of AIC in differentiating the shape and pathology of colorectal lesions is needed.

Links Between Perceptions and Practices in Patient Education: A Systematic Review

2019 ◽  
Vol 46 (6) ◽  
pp. 1001-1011 ◽  
Author(s):  
Sandrine Roussel ◽  
Mariane Frenay
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Education ◽  
Health Care Professionals ◽  
Quality Criteria ◽  
World Health ◽  
Health Organization ◽  
The Individual ◽  
Meta Analyses

Background. Two decades after “patient education” was defined by the World Health Organization, its integration in health care practices remains a challenge. Perceptions might shed light on these implementation difficulties. This systematic review aims to investigate links between perceptions and patient education practices among health care professionals, paying particular attention to the quality of practices in order to highlight any associated perception. Method. PubMed, PsycINFO, and Scopus were searched using the following search terms: “perceptions,” “patient education,” “health care professionals,” and “professional practices.” PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used. Results. Twenty studies were included. Overall findings supported the existence of links between some perceptions and practices. Links were either correlational or “causal” (generally in a single direction: perceptions affecting practices). Four types of perceptions (perceptions of the task including patient education, perceptions about the patient, perceptions of oneself as a health care professional, and perceptions of the context) were identified as being linked with educational practices. Links can although be mediated by other factors. Results concerning links should, however, be considered with caution as practices were mostly assessed by prevalence measurements, were self-reported and concerned exclusively individual education. When analyzing the quality of practices, the two retained studies highlighted their changing nature and the central role of perceptions with respect to the individual patient. Conclusions. This literature review led us to specify the quality criteria for further research: covering the entire spectrum of patient education, operationalizing variables, exploring specific practices, measuring the quality of practices, developing designs that facilitate causation findings, and considering a bidirectional perspective.

scholarly journals Effectiveness of Adjunctive Analgesics in Head and Neck Cancer Patients Receiving Curative (Chemo-) Radiotherapy: A Systematic Review

Pain Medicine ◽  
2020 ◽  
Author(s):  
Tessa Lefebvre ◽  
Laura Tack ◽  
Michelle Lycke ◽  
Fréderic Duprez ◽  
Laurence Goethals ◽  
...  
Keyword(s):  
Systematic Review ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Cochrane Collaboration ◽  
Cochrane Library ◽  
Head Neck Cancer ◽  
High Quality ◽  
Pain Outcome ◽  
Meta Analyses

Abstract Objective Our aim was to give an overview of the effectiveness of adjunctive analgesics in head and neck cancer (HNC) patients receiving (chemo-) radiotherapy. Design Systematic review. Interventions This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, Web of Science, the Cochrane Library, and ClinicalTrials.gov were searched for studies concerning “head neck cancer,” “adjunctive analgesics,” “pain,” and “radiotherapy.” Outcome Measures Pain outcome, adverse events, and toxicity and other reported outcomes, for example, mucositis, quality of life, depression, etc. Results Nine studies were included in our synthesis. Most studies were of low quality and had a high risk of bias on several domains of the Cochrane Collaboration tool. Only two studies comprised high-quality randomized controlled trials in which pregabalin and a doxepin rinse showed their effectiveness for the treatment of neuropathic pain and pain from oral mucositis, respectively, in HNC patients receiving (chemo-) radiotherapy. Conclusions More high-quality trials are necessary to provide clear evidence on the effectiveness of adjunctive analgesics in the treatment of HNC (chemo-) radiation-induced pain.

Interventions to Decrease Use in Prehospital and Emergency Care Settings Among Super-Utilizers in the United States: A Systematic Review

2019 ◽  
Vol 77 (2) ◽  
pp. 99-111 ◽  
Author(s):  
Samantha Iovan ◽  
Paula M. Lantz ◽  
Katie Allan ◽  
Mahshid Abir
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Acute Care ◽  
Emergency Care ◽  
Grey Literature ◽  
The United States ◽  
Care Utilization ◽  
Regression To The Mean ◽  
High Quality ◽  
The Impact

Interest in high users of acute care continues to grow as health care organizations look to deliver cost-effective and high-quality care to patients. Since “super-utilizers” of acute care are responsible for disproportionately high health care spending, many programs and interventions have been implemented to reduce medical care use and costs in this population. This article presents a systematic review of the peer-reviewed and grey literature on evaluations of interventions to decrease prehospital and emergency care use among U.S. super-utilizers. Forty-six distinct evaluations were included in the review. The most commonly evaluated intervention was case management. Although a number of interventions reported reductions in prehospital and emergency care utilization and costs, methodological and study design weaknesses—especially regression to the mean—were widespread and call into question reported positive findings. More high-quality research is needed to accurately assess the impact of interventions to reduce prehospital and emergency care use in the super-utilizer population.

scholarly journals The Implementation Chasm Hindering Genome-informed Health Care

2020 ◽  
Vol 48 (1) ◽  
pp. 119-125
Author(s):  
Kevin B. Johnson ◽  
Ellen Wright Clayton ◽  
Justin Starren ◽  
Josh Peterson
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Disease Management ◽  
High Quality ◽  
Healthcare Settings ◽  
Care Processes ◽  
Last Mile ◽  
New Knowledge ◽  
Health And Disease ◽  
The Impact

The promises of precision medicine are often heralded in the medical and lay literature, but routine integration of genomics in clinical practice is still limited. While the “last mile” infrastructure to bring genomics to the bedside has been demonstrated in some healthcare settings, a number of challenges remain — both in the receptivity of today's health system and in its technical and educational readiness to respond to this evolution in care. To improve the impact of genomics on health and disease management, we will need to integrate both new knowledge and new care processes into existing workflows. This change will be onerous and time-consuming, but hopefully valuable to the provision of high quality, economically feasible care worldwide.

P14.71 An assessment of the reporting and methodological quality of meningioma systematic reviews and meta-analyses

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii51-ii52
Author(s):  
A M George ◽  
S Gupta ◽  
S M Keshwara ◽  
M A Mustafa ◽  
C S Gillespie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Neurofibromatosis Type ◽  
Risk Of Bias ◽  
Measurement Tool ◽  
High Quality ◽  
Meta Analyses

Abstract BACKGROUND Systematic reviews and meta-analyses constitute the highest level of research evidence and for a disease with limited clinical trial activity, are often relied upon to help inform clinical practice. This review of reviews evaluates both the reporting & methodological quality of meningioma evidence syntheses. MATERIAL AND METHODS Potentially eligible meningioma reviews published between 1st January 1990 and 31st December 2020 were identified from eight electronic databases. Inclusion required the study to meet the Cochrane guideline definition of a systematic review or meta-analysis. Reviews concerning neurofibromatosis type 2, spinal and pediatric meningiomas were excluded. The reporting and methodological quality of articles were assessed against the following modified guidelines: Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), A MeaSurement Tool to Assess Systematic Reviews (AMSTAR2) and the Risk of Bias in Systematic Reviews (ROBIS) guidelines. RESULTS 117 systematic reviews were identified, 57 of which included meta-analysis (48.7%). The number of meningioma systematic reviews published each year has increased with 63 studies (53.9%) published between 01/2018 and 12/2020. A median of 17 studies (IQR 9–29) were included per review. Impact factor of journals publishing a systematic review with or without a meta-analysis was similar (median 2.3 vs 1.8, P=0.397). The mean PRISMA scores for systematic reviews with a meta-analysis was 21.11 (SD 4.1, 78% adherence) and without was 13.89 (SD 3.4, 63% adherence). Twenty-nine systematic reviews with meta-analysis (51%) and 11 without meta-analysis (18%) achieved greater than 80% adherence to PRISMA recommendations. Methodological quality assessment using AMSTAR2 revealed one study (0.9%) as high quality whilst 111 (94.8%) studies were graded as critically low. One hundred and two articles (87.2%) did not utilize a comprehensive search strategy as defined by the AMSTAR2 tool. Ninety-nine studies (84.6%) obtained a high level of concern for potential bias as per the ROBIS assessment. One hundred and eight articles (92.3%) failed to present information that a protocol had been established prior to study commencement and 76 articles (65.0%) did not conduct a risk of bias assessment. Across the three tools, domains relating to the establishment of a protocol prior to review commencement and conducting appropriate risk of bias assessments were frequently low scoring. CONCLUSION Overall reporting and methodological quality of meningioma systematic reviews was sub-optimal. Established critical appraisal tools and reporting guidelines should be utilized a priori to assist in producing high-quality systematic reviews.

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