scholarly journals Development of a Risk Assessment Tool for Falls Prevention in Hospital Inpatients Based on the Medication Appropriateness Index (MAI) and Modified Beer's Criteria

2012 ◽  
Vol 3 (1) ◽  
Author(s):  
Martha M. Rumore ◽  
Georgeta Vaidean
Keyword(s):  
Medication Review ◽  
Assessment Tool ◽  
Inappropriate Prescribing ◽  
Falls Prevention ◽  
Beers Criteria ◽  
Medication Appropriateness Index ◽  
Assessment Index ◽  
Advantages And Disadvantages ◽  
Hospital Inpatients ◽  
Elderly Hospitalized Patients

Medication review is an essential component of comprehensive falls assessment. A medication review by pharmacists can assist to identify and notify prescribers of medications that require adjustment or discontinuation. Beers Criteria and the Medication Assessment Index (MAI) are explicit and implicit inappropriate prescribing (IP) tools, respectively. While the Beers Criteria has been applied to falls prevention, the MAI has not. Developing alternative falls prevention tools has been spurned by both the desire to overcome limitations of the Beers Criteria, coupled with the need for implicit criteria which includes consideration for patient äóñspecific clinical judgement. A literature search and review of the Beers Criteria and MAI tools revealed advantages and disadvantages of each. Using combined explicit/implicit falls assessment criteria using both the Beers Criteria and MAI as a framework, a falls specific inappropriate prescribing (FASPIP) tool for use in elderly hospitalized patients was developed. Validation of the FASPIP in the clinical setting is needed.   Type: Review

scholarly journals A Collaborative Medication Review Including Deprescribing for Older Patients in an Emergency Department: A Longitudinal Feasibility Study

2020 ◽  
Vol 9 (2) ◽  
pp. 348 ◽  
Author(s):  
Morten Baltzer Houlind ◽  
Aino Leegaard Andersen ◽  
Charlotte Treldal ◽  
Lillian Mørch Jørgensen ◽  
Pia Nimann Kannegaard ◽  
...  
Keyword(s):  
Emergency Department ◽  
Medication Review ◽  
Older Patients ◽  
Inappropriate Prescribing ◽  
Medical Patients ◽  
Medication Appropriateness Index ◽  
Interaction Database ◽  
Number Of Patients ◽  
Stopp Criteria

Medication review for older patients with polypharmacy in the emergency department (ED) is crucial to prevent inappropriate prescribing. Our objective was to assess the feasibility of a collaborative medication review in older medical patients (≥65 years) using polypharmacy (≥5 long-term medications). A pharmacist performed the medication review using the tools: Screening Tool of Older Persons’ potentially inappropriate Prescriptions (STOPP) criteria, a drug–drug interaction database (SFINX), and Renbase® (renal dosing database). A geriatrician received the medication review and decided which recommendations should be implemented. The outcomes were: differences in Medication Appropriateness Index (MAI) and Assessment of Underutilization Index (AOU) scores between admission and 30 days after discharge and the percentage of patients for which the intervention was completed before discharge. Sixty patients were included from the ED, the intervention was completed before discharge for 50 patients (83%), and 39 (61.5% male; median age 80 years) completed the follow-up 30 days after discharge. The median MAI score decreased from 14 (IQR 8-20) at admission to 8 (IQR 2-13) 30 days after discharge (p < 0.001). The number of patients with an AOU score ≥1 was reduced from 36% to 10% (p < 0.001). Thirty days after discharge, 83% of the changes were sustained and for 28 patients (72%), 1≥ medication had been deprescribed. In conclusion, a collaborative medication review and deprescribing intervention is feasible to perform in the ED.

scholarly journals The Prevalence of Potentially Inappropriate Prescribing in Geriatric Patients with Psychiatric Disorders in Iraq

2020 ◽  
Vol 29 (1) ◽  
pp. 166-173
Author(s):  
Mustafa K. Mahmood ◽  
Zinah M. Anwer
Keyword(s):  
Geriatric Patients ◽  
Assessment Tool ◽  
Psychiatric Patients ◽  
Inappropriate Medication ◽  
Inappropriate Prescribing ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Beers Criteria ◽  
Potentially Inappropriate Prescribing ◽  
Cross Sectional

Potentially inappropriate prescribing is the prescribing of a medication that may cause more harm than benefit, the elderly population aged 65 years or older is more prone to potentially inappropriate prescribing because of alterations in their physiology, pharmacokinetics, and pharmacodynamics as well as polypharmacy and comorbidities, Beers list is a screening tool that help doctors to detect potentially inappropriate prescribing in geriatric patients and is designed to solve this problem, the aim of this study is to measure the prevalence of potentially inappropriate prescribing among psychiatric patients using the Beers criteria as an assessment tool and find the relationship between duration of hospitalization, comorbidities and polypharmacy with potentially inappropriate prescribing in elderly. This cross-sectional study was carried out using electronic medical records in Ibn Rushud psychiatry and addiction hospital in Baghdad and 369 patients were included. The mean age of the patients was (68.59 ± 3.75 years) and 177 (48%) of them had comorbidities, 100 (27.1%) of them had polypharmacy and 17 (4.6%) stayed in the hospital for more than 3 weeks, the most used drug classes were antipsychotics in (39.9%) of patients and benzodiazepines in (17.6%) of patients. The prevalence of potentially inappropriate prescribing according to Beers criteria was found to be 74.3% among study patients, the most prevalent inappropriately used drug class was benzodiazepines, and there was a significant association between the prescribing of a potentially inappropriate medication with gender (p=0.018), with comorbidities (p=0.022), and a very significant association with polypharmacy (p<0.001)

scholarly journals Beers Criteria as a Proxy for Inappropriate Prescribing of Other Medications Among Older Adults

2011 ◽  
Vol 45 (11) ◽  
pp. 1363-1370 ◽  
Author(s):  
Brian C Lund ◽  
Michael A Steinman ◽  
Elizabeth A Chrischilles ◽  
Peter J Kaboli
Keyword(s):  
Older Adults ◽  
Inappropriate Prescribing ◽  
Quality Measurement ◽  
Future Research ◽  
Beers Criteria ◽  
Prescribing Practices ◽  
Medication Appropriateness Index ◽  
Prescribing Quality ◽  
Proxy Measure ◽  
Expert Clinician

Background:: The Beers criteria are a compilation of medications deemed potentially inappropriate for older adults, widely used as a prescribing quality indicator. Objective: To determine whether Beers criteria serve as a proxy measure for other forms of inappropriate prescribing, as measured by comprehensive implicit review. Methods: Data for patients 65 years and older were obtained from the Veterans Affairs Enhanced Pharmacy Outpatient Clinic (EPOC) and the Iowa Medicaid Pharmaceutical Case Management (PCM) studies. Comprehensive measurement of prescribing quality was conducted using expert clinician review of medical records according to the Medication Appropriateness Index (MAI). MAI scores attributable to non-Beers medications were contrasted between patients who did and did not receive a Beers criteria medication. Results: Beers criteria medications accounted for 12.9% (EPOC) and 14.0% (PCM) of total MAI scores. Importantly, non-Beers MAI scores were significantly higher in patients receiving a Beers criteria medication in both studies (EPOC: 15.1 vs 12.4, p = 0.02; PCM: 11.1 vs 8.7, p = 0.04), after adjusting for important confounding factors. Conclusions: Beers criteria utility extended beyond direct measurement of a limited set of inappropriate prescribing practices by serving as a clinically meaningful proxy for other inappropriate practices. Using prescribing quality indicators to guide interventions should thus identify patients for comprehensive medication review, rather than identifying specific medication targets for discontinuation. Future research should explore both the quality measurement and the intervention targeting applications of the Beers criteria, particularly when integrated with other indicators.

scholarly journals Identification of inappropriate prescribing in a Brazilian nursing home using STOPP/START screening tools and the Beers' Criteria

2014 ◽  
Vol 50 (4) ◽  
pp. 911-918 ◽  
Author(s):  
Mariana Martins Gonzaga Nascimento ◽  
Andréia Queiroz Ribeiro ◽  
Mariana Linhares Pereira ◽  
Adriana Cristina Soares ◽  
Antônio Ignácio de Loyola Filho ◽  
...  
Keyword(s):  
Nursing Home ◽  
Medical Records ◽  
Inappropriate Medication ◽  
Inappropriate Prescribing ◽  
Cross Sectional Study ◽  
Screening Tools ◽  
Beers Criteria ◽  
Cross Sectional ◽  
The Past ◽  
Prescribing Omissions

The objective of this study was to determine the prevalence of Potentially Inappropriate Medication (PIM) use and associated factors, as well as the prevalence of Prescribing Omissions (PO). A cross-sectional study was conducted in a philanthropic Brazilian nursing home involving 46 individuals aged 60 years or older. The following information was collected from medical records and drug prescriptions: gender, age, health conditions and drugs used in the past thirty days. PIM and PO were identified according to the Beers' Criteria and the STOPP/START screening tools. Over one third (37%) of the population used at least one PIM according to the Beers' Criteria (n=17) and 60.9% according to the STOPP tool. A significant association was found between polypharmacy (use of five or more drugs) and use of PIM according to the Beers' Criteria, but not according to the STOPP. Eight residents (17.4%) were exposed to eight PO. This study allowed the diagnosis of a concerning drug utilization profile with use of a high number of PIMs. Thus, there is an evident need to implement strategies for improving geriatric prescription.

scholarly journals Opportunities and Questions: A Short Report on Rubric Assessments in Asia and the Middle East

2019 ◽  
Author(s):  
Ronnie Goodwin
Keyword(s):  
Middle East ◽  
Assessment Tool ◽  
Relevant Literature ◽  
Alternative Methods ◽  
Learning Theories ◽  
Short Report ◽  
Rating Systems ◽  
Self Assessment ◽  
Advantages And Disadvantages ◽  
The Impact

This qualitative short report considers the viability of the use of rubrics or alternative methods to assess writing in Asia and the Middle East. The background of learning theories, assessment types, and self-assessment literature provides a foundation for further discussion of the appropriate use of rubrics, including the prioritization of criterion, the quality of scoring, the impact of organizational features on scoring, the influence of bias, and the best application of rubric assessment. Relevant points for further study are identified, such as differentiation in research between generalized analytical rating systems and rubric assessment with specific, empirical criterion. The contradictory research regarding the advantages and disadvantages of rubric assessment in comparison with holistic assessment are of particular and crucial interest for global pedagogy. Many of the reviewed Western articles excluded Asian perspectives- except for China- and thus present a limited understanding of social and educational compatibility with new assessments and rubric assessments in particular. The discussion identifies patterns and points of contention and seeks to explore viewpoints rather than limit the scope of inquiry and consideration thus noting that relevant literature suggests that with appropriate teacher training, teachers may appropriately use rubrics as a formative assessment tool for writing in Asia and the Middle East.

scholarly journals Assessment of Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward According to the 2019 Beers Criteria

2020 ◽  
Vol 03 (02) ◽  
Author(s):  
Cátia Pereira ◽  
Ana Guiomar ◽  
Alexandra Cunha ◽  
Catarina Alves Cunha ◽  
José Pedro Barbosa ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Elderly Patients ◽  
Inappropriate Prescribing ◽  
Beers Criteria ◽  
Internal Medicine Ward

The evidence for introducing case-finding for delirium and dementia in older medical inpatients in a New Zealand hospital

2022 ◽  
pp. 103985622110624
Author(s):  
Sarah Cullum ◽  
Yezen Kubba ◽  
Chris Varghese ◽  
Christin Coomarasamy ◽  
John Hopkins
Keyword(s):  
Cognitive Impairment ◽  
New Zealand ◽  
Length Of Stay ◽  
Assessment Tool ◽  
Hospital Costs ◽  
Case Finding ◽  
Risk Of Death ◽  
Lengths Of Stay ◽  
Medical Wards ◽  
Hospital Inpatients

Objective The aim of this project was to make the case to the managers of a large urban teaching hospital in New Zealand for the introduction of systematic case-finding for pre-existing cognitive impairment/dementia in older hospital inpatients that screen positive for delirium. Method Two hundred consecutive acute admissions aged 75+ in four medical wards were assessed using the 4AT assessment tool for delirium and the Alzheimer Questionnaire (AQ) for pre-existing cognitive impairment/dementia. Length of stay and mortality at 1 year were also collected. Results Over a third of the sample screened positive for delirium and nearly two-thirds of these also screened positive for dementia. The median length of stay was 5 days for delirium without dementia and 7 days for delirium with dementia, compared to 3 days for those who screened negative for both. After adjustment for age, gender and ethnic group, people who screened positive for delirium (with or without dementia) had 50% longer length of stay ( p < 0.05) and at least double the risk of death ( p < 0.05). Conclusion Older hospital inpatients that screen positive for delirium and dementia using 4AT and AQ have longer lengths of stay and higher mortality. Identification may lead to more timely interventions that help to improve health outcomes and reduce hospital costs.

An assessment tool for healthcare waste management in Brazilian municipalities during the COVID-19 pandemic

2021 ◽  
pp. 0734242X2110452
Author(s):  
Flávia Tuane Ferreira Moraes ◽  
Andriani Tavares Tenório Gonçalves ◽  
Josiane Palma Lima ◽  
Renato da Silva Lima
Keyword(s):  
Waste Management ◽  
Rating Scale ◽  
Assessment Tool ◽  
Analytic Hierarchy ◽  
Assessment Index ◽  
Healthcare Waste ◽  
Health Agencies ◽  
Healthcare Waste Management ◽  
Political Economic ◽  
Hierarchy Process

The COVID-19 pandemic has put healthcare waste management (HCWM) systems under pressure worldwide. In Brazil, where municipalities routinely experience challenges in ensuring suitable disposal of healthcare waste (HCW), the pandemic has made this even more challenging. Therefore, the creation of tools and methods to help in municipal HCWM during the COVID-19 pandemic is of utmost importance. This article presents the development of a tool to evaluate HCWM in Brazilian municipalities during the pandemic. Following guidelines of health agencies, 56 indicators and 18 criteria were selected to create a tool called the municipal healthcare waste management assessment index (iMHWaste). These indicators and criteria were divided into operational, environmental, political–economic, educational and social groups. Each group considers essential aspects for sustainable management, safety and reduced spread of coronavirus. The analytic hierarchy process was used to assign the weights attributed to the groups and criteria. The indicators can be measured according to a standardized rating scale proposed for each one. These elements were aggregated with a weighted linear combination, into an equation that allows the calculation of the iMHWaste. The index is rated on a scale of 0–1. The index was applied in a Brazilian municipality considering a pre-pandemic HCWM. With the identification of the municipality’s management weaknesses, it was possible to identify the main actions that should be prioritized in the transition from traditional HCWM during the pandemic.

A Game-Based Student Response System

2022 ◽  
pp. 903-915
Author(s):  
Funda Ergulec ◽  
Özge Misirli
Keyword(s):  
Higher Education ◽  
Assessment Tool ◽  
Student Response ◽  
Student Response System ◽  
Game Based Learning ◽  
Immediate Feedback ◽  
Advantages And Disadvantages ◽  
Response System ◽  
Learning Platform ◽  
Teachers Perspectives

In this chapter, a game-based student response system, Kahoot!, is investigated. The purpose of the chapter was to analyze instructors and pre-service teachers' perspectives about the use of this platform. The advantages and disadvantages of integrating this tool in the classroom was investigated. Pre-service teachers' feedback and instructors' experiences using Kahoot! in higher education classrooms indicate that pre-service teachers welcome the use of these kind of games. Kahoot! can be used not only to increase student participation in the classroom but also as a formative assessment tool. Kahoot! can provide an engaging learning environment and adds active participation in the classroom by appealing even the most introverted students. In addition, immediate feedback feature of this game-based learning platform provides opportunities for instructors to tailor their instruction based on student understanding on games.

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