A Controlled Randomized Prospective Comparative Pilot Study to Evaluate the Ease of Use of a Transparent Chlorhexidine Gluconate Gel Dressing Versus A Chlorhexidine Gluconate Disk in Healthy Volunteers

2008 ◽  
Vol 13 (3) ◽  
pp. 112-117 ◽  
Author(s):  
Chou I. Eyberg ◽  
Janine Pyrek
Keyword(s):  
Health Care ◽  
Pilot Study ◽  
Healthy Volunteers ◽  
Health Care Professionals ◽  
Rating Scale ◽  
Insertion Site ◽  
Chlorhexidine Gluconate ◽  
Ease Of Use ◽  
Performance Factors ◽  
And Performance

Abstract Products and technologies that aid health care professionals in vascular access practice save staff time, and while promoting patient safety and prevention of infection can provide excellent opportunities for evaluations to support evidence-based practice. This was an industry sponsored, prospective, single site, controlled, randomized clinical evaluation pilot study of two catheter dressings, 3M™ Tegaderm™ Chlorhexidine Gluconate (CHG) IV Securement Dressing (CHG gel dressing) (3M Health Care, St. Paul, MN) and BIOPATCH® Antimicrobial Dressing with Chlorhexidine Gluconate (BIOPATCH® Protective Disk with CHG, Johnson & Johnson, Somerville, NJ). Twelve intravascular (IV) therapy health care professionals (Clinicians) were asked for their professional evaluations of the catheter dressings: the ease of application and performance factors featured in specific questions. Catheters were secured on 12 healthy volunteers to simulate inserted jugular catheters (IJ) and peripherally inserted central catheters (PICC) using StatLock® PICC Plus and 3M™ Steri-Strip™. Each clinician applied and removed one CHG gel dressing and one CHG disk on one simulated PICC and one simulated IJ site, according to the manufacturers' instructions. The clinicians concluded, based upon a 1 to 5 rating scale, that the CHG gel dressing is better in regard to ease of application, ease of applying correctly, ease of removal, ability to visualize the insertion site, ease of training another clinician to apply the dressing, and more intuitive application. Twelve out of 12 clinicians favored the CHG gel dressing over the CHG disk in overall performance.

Clinical Performance of a New Transparent Chlorhexidine Gluconate Central Venous Catheter Dressing

2008 ◽  
Vol 13 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Carol Olson ◽  
James M. Heilman
Keyword(s):  
Health Care ◽  
Central Venous Catheter ◽  
Vascular Access ◽  
New Technologies ◽  
Insertion Site ◽  
Venous Catheter ◽  
Chlorhexidine Gluconate ◽  
Ease Of Use ◽  
Central Venous ◽  
Or Education

Abstract As the sciences of vascular access and infection prevention rapidly advance healthcare professionals are often faced with new technologies designed to help, but which are often so complicated to use that they cause unforeseen problems. As a vascular access team at a major mid-western hospital, we evaluated the ease-of-use and the performance characteristics of a new transparent catheter dressing, 3M Tegaderm CHG IV Securement Dressing® (3M Health Care™, St. Paul, MN) containing the antimicrobial chlorhexidine gluconate (CHG), with a variety of central venous catheters insertion sites in comparison to a standard non-antimicrobial dressing Tegaderm® (3M Health Care™, St. Paul, MN). Following IRB approval, sixty-three consenting patients were enrolled and randomized; 33 in the CHG antimicrobial dressing group and 30 in the standard dressing group. Thirty six patients had peripherally inserted central catheters (PICCs), 20 had intrajugular insertions (IJ), and 7 had subclavian insertions. The new 3M Tegaderm CHG IV Securement Dressing® (3M Health Care™, St. Paul, MN) was evaluated for its ability to permit visualization of the insertion site, ease of use, ease of using correctly, ability to secure the catheter and absorb exudates and remain transparent. The new 3M Tegaderm CHG IV Securement Dressing® (3M Health Care™, St. Paul, MN) was found to be as easy to use in central venous catheter care clinical practice as the standard of care non-antimicrobial transparent adhesive dressing. No additional training or education was required to properly use it. This dressing was applied and removed like standard transparent adhesive dressings, but offered many advantages over standard dressings. Advantages include that it is antimicrobial, handles moderate bleeding, remains transparent and appears to offer greater catheter securement than the Tegaderm® (3M Health Care™, St. Paul, MN) standard dressing. The CHG gel pad also conformed well to the catheter.

scholarly journals In-Home Telerehabilitation for Post-Knee Arthroplasty: A Pilot Study

2009 ◽  
Vol 1 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Michel Tousignant ◽  
Patrick Boissy ◽  
Hélène Corriveau ◽  
Hélène Moffet ◽  
François Cabana
Keyword(s):  
Health Care ◽  
Pilot Study ◽  
Acute Care ◽  
Knee Arthroplasty ◽  
Health Care Professionals ◽  
Acute Care Hospital ◽  
Rehabilitation Services ◽  
Control Group ◽  
Care Hospital ◽  
Post Discharge

The purpose of this study was to investigate the efficacy of in-home telerehabilitation as an alternative to conventional rehabilitation services following knee arthroplasty. Five community-living elders who had knee arthroplasty were recruited prior to discharge from an acute care hospital. A pre/post-test design without a control group was used for this pilot study. Telerehabilitation sessions (16) were conducted by two trained physiotherapists from a service center to the patient’s home using H264 videoconference CODECs (Tandberg 550 MXP) connected at 512 Kb\s. Disability (range of motion, balance and lower body strength) and function (locomotor performance in walking and functional autonomy) were measured in face-to-face evaluations prior to and at the end of the treatments by a neutral evaluator. The satisfaction of the health care professional and patient was measured by questionnaire. Results are as follows. One participant was lost during follow-up. Clinical outcomes improved for all subjects and improvements were sustained two months post-discharge from in-home telerehabilitation. The satisfaction of the participants with in-home telerehabilitation services was very high. The satisfaction of the health care professionals with the technology and the communication experience during the therapy sessions was similar or slightly lower. In conclusion, telerehabilitation for post-knee arthroplasty is a realistic alternative for dispensing rehabilitation services for patients discharged from an acute care hospital.Keywords: Telerehabilitation, Physical Therapy, Total Knee Arthroplasty, Videoconferencing

scholarly journals Understanding the Adoption and Diffusion of a Telemonitoring Solution in Gestational Diabetes Mellitus: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Carine Khalil
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Health Care Professionals ◽  
Ease Of Use ◽  
Research Approach ◽  
Semistructured Interviews ◽  
Adoption And Diffusion ◽  
And Diffusion

BACKGROUND Women with gestational diabetes mellitus (GDM) require regular follow-ups and overall management to normalize maternal blood glucose and improve pregnancy outcomes. With the advancements made in the digital field, telemedicine is gaining popularity over traditional health care approaches in different medical fields. As for GDM, telemonitoring solutions seem to improve women’s quality of life and enhance self-management. OBJECTIVE The aim of this study is to understand, from patients’ and health care professionals’ (HCPs) perspectives, what drives the adoption and diffusion of a telemonitoring solution (myDiabby) in a context where telemonitoring activities are still not compensated like traditional follow-ups. METHODS The study was conducted in 12 diabetes services in France using myDiabby for monitoring and managing patients with GDM. A qualitative research approach was adopted for collecting and analyzing data. A total of 20 semistructured interviews were conducted with HCPs working in different health structures in France, and 15 semistructured interviews were conducted with patients who had been using myDiabby. Data were analyzed using a thematic analysis approach. RESULTS Different determinants need to be taken into consideration when adopting an innovative health technology. By drawing on the diffusion of innovation theory, a set of factors associated with the technology (the relative advantages, compatibility, ease of use, testability, and observability of the telemedicine platform) has been identified as affecting the adoption and diffusion of telemonitoring solutions in French diabetes services. In addition, data analysis shows a set of environmental factors (the demographic situation of HCPs, the health care access in rural communities, and the economic and political context in France) that also influences the spread and adoption of telemonitoring systems in French hospitals. CONCLUSIONS Even though telemonitoring activities are still not remunerated as traditional follow-ups, many French HCPs support and encourage the adoption of telemonitoring systems in GDM. As for patients, telemonitoring systems are perceived as a useful and easy way to monitor their GDM. This study contributes to recognizing the value of telemonitoring interventions in managing GDM and considering the expansion of telemonitoring to other chronic conditions.

scholarly journals Assessing Apps for Patients with Genitourinary Tumors Using the Mobile Application Rating Scale (MARS): Systematic Search in App Stores and Content Analysis (Preprint)

2019 ◽  
Author(s):  
Miguel Ángel Amor-García ◽  
Roberto Collado-Borrell ◽  
Vicente Escudero-Vilaplana ◽  
Alejandra Melgarejo-Ortuño ◽  
Ana Herranz-Alonso ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Mobile Application ◽  
Rating Scale ◽  
Cross Sectional ◽  
Cancer Symptoms ◽  
Genitourinary Cancers

BACKGROUND The large number of available cancer apps and their impact on the population necessitates a transparent, objective, and comprehensive evaluation by app experts, health care professionals, and users. To date, there have been no analyses or classifications of apps for patients with genitourinary cancers, which are among the most prevalent types of cancer. OBJECTIVE The objective of our study was to analyze the quality of apps for patients diagnosed with genitourinary cancers using the Mobile Application Rating Scale (MARS) and identify high-quality apps. METHODS We performed an observational cross-sectional descriptive study of all smartphone apps for patients diagnosed with genitourinary cancers available on iOS and Android platforms. In July 2019, we searched for all available apps for patients with genitourinary cancers (bladder, prostate, cervical, uterine, endometrial, kidney, testicular, and vulvar) or their caregivers. Apps were downloaded and evaluated, and the general characteristics were entered into a database. The evaluation was performed by 2 independent researchers using the MARS questionnaire, which rates 23 evaluation criteria clustered in 5 domains (Engagement, Functionality, Esthetics, Information, and Subjective Quality) on a scale from 1 to 5. RESULTS In total, 46 apps were analyzed. Of these, 31 (67%) were available on Android, 6 (13%) on iOS, and 9 (20%) on both platforms. The apps were free in 89% of cases (41/46), and 61% (28/46) had been updated in the previous year. The apps were intended for prostate cancer in 30% of cases (14/46) and cervical cancer in 17% (8/46). The apps were mainly informative (63%, 29/46), preventive (24%, 11/46), and diagnostic (13%, 6/46). Only 7/46 apps (15%) were developed by health care organizations. The mean MARS score for the overall quality of the 46 apps was 2.98 (SD 0.77), with a maximum of 4.63 and a minimum of 1.95. Functionality scores were quite similar for most of the apps, with the greatest differences in Engagement and Esthetics, which showed acceptable scores in one-third of the apps. The 5 apps with the highest MARS score were the following: “Bladder cancer manager,” “Kidney cancer manager,” “My prostate cancer manager,” “Target Ovarian Cancer Symptoms Diary,” and “My Cancer Coach.” We observed statistically significant differences in the MARS score between the operating systems and the developer types (<i>P</i>&lt;.001 and <i>P</i>=.01, respectively), but not for cost (<i>P</i>=.62). CONCLUSIONS MARS is a helpful methodology to decide which apps can be prescribed to patients and to identify which features should be addressed to improve these tools. Most of the apps designed for patients with genitourinary cancers only try to provide data about the disease, without coherent interactivity. The participation of health professionals in the development of these apps is low; nevertheless, we observed that both the participation of health professionals and regular updates were correlated with quality.

Barriers in the Decision Making About and Performance of Continuous Sedation Until Death in Nursing Homes

2019 ◽  
Vol 60 (5) ◽  
pp. 916-925
Author(s):  
Lenzo Robijn ◽  
Luc Deliens ◽  
Judith Rietjens ◽  
Peter Pype ◽  
Kenneth Chambaere
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Nursing Homes ◽  
Health Care Professionals ◽  
Comparative Approach ◽  
Organizational Barriers ◽  
Organization Of Care ◽  
Continuous Sedation ◽  
And Performance ◽  
Design And Methods

Abstract Background and Objectives While decision making about and performance of continuous sedation involve many challenges, they appear to be particularly pervasive in nursing homes. This study aims to identify barriers to the decision making and performance of continuous sedation until death in Flemish nursing homes as experienced by the health care professionals involved. Research Design and Methods Ten focus groups were held with 71 health care professionals including 16 palliative care physicians, 42 general practitioners, and 13 nursing home staff. Discussions were transcribed verbatim and analyzed using a constant comparative approach. Results Perceived barriers concerned factors prior to and during sedation and were classified according to three types: (a) personal barriers related to knowledge and skills including the lack of clarity on what continuous sedation should be used for (linguistic ambiguity) and when and how it should be used (practical ambiguity); (b) relational barriers concerning communication and collaboration both between health care professionals and with family; (c) organizational barriers related to the organization of care in nursing homes where, for example, there is no on-site physician, or where the recommended medication is not always available. Discussion and Implications The findings suggest there are considerable challenges for sound decision making about and performance of continuous sedation until death in nursing homes. There is a need for multicomponent initiatives that provide guidance in the context of the complexity of a resident’s medical situation, the family, and the specific organization of care, which would have the potential to facilitate and improve the decision-making process and performance of continuous sedation in nursing homes.

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