Chronic Disease Registers in Primary Healthcare

2011 ◽  
pp. 35-43
Author(s):  
M. F. Harris ◽  
D. Penn ◽  
J. Taggart ◽  
Andrew Geogious ◽  
J. Burns ◽  
...  
Keyword(s):  
At Risk ◽  
Chronic Disease ◽  
Primary Healthcare ◽  
Clinical Care ◽  
Evidence Based ◽  
Critical Data ◽  
Structured Care ◽  
Patients At Risk ◽  
Evidence Based Guidelines ◽  
Provision Of Care

Systematic care of patients with chronic diseases needs to be underpinned by information systems such as disease registers. Their primary function is to facilitate structured care of patients attending services—supporting identification of patients at risk, structured preventive care and provision of care according to guidelines, and supporting recall of patients for planned visits. In Australia general practitioners using division-based diabetes registers are more likely to provide patient care that adhered to evidence-based guidelines. Critical data issues include privacy, ownership, compatability, and capture as part of normal clinical care and quality.

Are Hospitals Following Guidelines for VTE Prevention? the Veneous Thromoembolism Study to Assess the Rate of Thromboprophylaxis

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1286-1286
Author(s):  
Alpesh Amin ◽  
Alex Spyropoulos ◽  
Paul Dobesh ◽  
Andrew Shorr ◽  
Mohamed Hussein ◽  
...  
Keyword(s):  
At Risk ◽  
Critical Care ◽  
Hospitalized Patients ◽  
Evidence Based ◽  
Inpatient Stay ◽  
Medically Ill ◽  
Rural And Urban ◽  
Patients At Risk ◽  
Care Surgery ◽  
Evidence Based Guidelines

Abstract OBJECTIVE: The 7th conference of the American College of Chest Physicians (ACCP7) provides evidence-based guidelines on the type, dose, and duration of thromboprophylaxis in hospitalized patients at risk of venous thromboembolism (VTE), but the extent to which hospitals follow these criteria has not been well studied. METHODS: Discharge and billing records for patients admitted to any of 16 rural and urban U.S. acute-care hospitals from January 2005 to December 2006 were obtained. Patients 18 years or older who had an inpatient stay 32 days and no apparent contraindications for thromboprophylaxis were grouped into the categories of critical care, surgery and medically ill before being assessed for additional VTE risk factors based on the diagnostic criteria outlined in ACCP7. For patients considered “at risk”, the recommended type (mechanical or pharmacologic), dose, and duration of thromboprophylaxis was identified based on the guidelines and compared to the regimen actually received, if any. RESULTS: Among the 258,556 hospitalized patients, 68,278 (26.4%) were determined to be at risk of VTE without apparent contraindications for thromboprophylaxis. The proportions of patients who received the appropriate type and dose and duration of thromboprophylaxis were 10.5%, 9.8%, and 17.9% for critical care, medical, and surgical patients, respectively. Of those at risk, 36.8% received no thromboprophylaxis and an additional 50.2% received thromboprophylaxis deemed inappropriate for one or more reasons. CONCLUSIONS: The implementation of ACCP7 guidelines for type, dosage, and duration of thromboprophylaxis is low in patients at risk of VTE. Fewer than 1 in 7 patients received thromboprophylaxis that met criteria for recommended type, dose and duration. The findings demonstrate a worrisome gap in the performance of evidence-based thromboprophylaxis for hospitalized patients. There is a need for physicians and health systems to improve the levels of awareness and implementation of recommended thromboprophylaxis.

Stage one seminoma: Evidence based guidelines for follow up

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4546-4546
Author(s):  
J. M. Martin ◽  
T. Panzarella ◽  
D. R. Zwahlen ◽  
P. W. Chung ◽  
P. Warde
Keyword(s):  
At Risk ◽  
Prospective Studies ◽  
Management Strategies ◽  
Evidence Based ◽  
Weighted Mean ◽  
Kaplan Meier ◽  
Cochrane Database ◽  
Patients At Risk ◽  
Evidence Based Guidelines

4546 Background: Several management strategies are used following ochiectomy for stage one seminoma (SOS) of the testis. The aim of this systematic review (SR) is to provide evidence based guidelines for the follow-up (FU) schedule for each strategy regarding investigations required, frequency of assessment and overall duration. Methods: A SR of all prospective studies in SOS published since 1980 in MEDLINE, EMBASE and the Cochrane database was performed in November 2005. Data was extracted regarding the time, location and method of detection of first relapses, duration of FU, relapse free rates, and numbers of patients at risk. Five strategies were identified: Surveillance (S), Extended-field Radiotherapy (EFRT), Para-aortic Radiotherapy (PART) and either one (C1) or two (C2) cycles of Carboplatin chemotherapy. For each strategy Kaplan-Meier relapse free estimates were used to calculate weighted mean cumulative hazards of relapse over time. These were used to calculate yearly weighted mean relapse hazards. Weights used were based on numbers of patients at risk in each trial. Results: Fifteen prospective studies with a total of 5277 patients were identified. Actuarial relapse data was available in 4185 (79.3%) patients and 4850 (91.9%) had the location of relapse documented. Method of relapse detection was infrequently reported. The median time to relapse with all strategies was 12–16 months. Annual hazard ratios for relapse decreased with increasing length of FU and relapse location depended on the strategy used ( Table ). Conclusions: 1. The investigations performed need to reflect locations at risk of relapse. This should include computerised tomography (CT) of the abdomen and pelvis for Survillance and adjuvant Carboplatin, with CT of the pelvis only for Para-aortic RT. 2. Long term FU data on patients treated with Carboplatin is not available, and further FU is necessary. 3. Frequency of FU should reflect the annual hazard of relapse. We suggest 3 times per year when the risk is >5%, 2 times per year when the risk is 1–5%, and annually until the risk is <0.3%. [Table: see text] No significant financial relationships to disclose.

scholarly journals Encountering suicide in primary healthcare rehabilitation: the experiences of physiotherapists

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Åse Lundin ◽  
Anna Bergenheim
Keyword(s):  
At Risk ◽  
Healthcare System ◽  
Primary Healthcare ◽  
Qualitative Content Analysis ◽  
Western Hemisphere ◽  
Mental Wellbeing ◽  
Healthcare Personnel ◽  
Public Health Issue ◽  
Structured Interviews ◽  
Patients At Risk

Abstract Background Suicide is a serious public health issue and one of the most common causes of death globally. Suicide has long-lasting impact on personal, relational, community and societal levels. Research has shown that patients often seek help in the primary healthcare system preceding a suicide. Studies exploring the experiences of encountering patients at risk for suicide have been performed among various categories of healthcare personnel, such as nurses and psychiatry residents as well as emergency room staff. There is a lack of research regarding primary healthcare rehabilitation staff, despite the fact that physiotherapists are the third largest health profession in the Western hemisphere and often work with patients experiencing mental health symptoms. The aim of this study was to explore the experiences of encountering patients at risk for suicide among physiotherapists working in a primary healthcare rehabilitation setting. Methods Semi-structured interviews were conducted with 13 physiotherapists working in primary healthcare rehabilitation clinics in the Gothenburg area, Sweden. The interviews were recorded on audio and transcribed into written text. A qualitative content analysis was performed on the material collected. Results The analysis of the material revealed an overarching theme, Through barriers and taboos – the physiotherapist finds a way, with five main categories: possibilities for identification, obstacles in meeting suicide, workplace environment matters, where does the patient belong? and education and experience are keys. Conclusions The present study indicates that physiotherapists in the primary healthcare system encounter patients experiencing suicidality, and they expressed a strong desire to care for both the physical and mental wellbeing of the patients. Despite reporting many barriers, the physiotherapists often found a way to form a meaningful therapeutic alliance with the patient and to ask about possible suicidality in their clinical practice. The result suggests that physiotherapists could play a larger role in working with patients experiencing suicidality in a primary healthcare setting and that they could be viewed as possible gatekeepers in identification as well as referral of these patients into other parts of the healthcare system.

Evidence-based guidelines for acute stabilization and management of neonates with persistent pulmonary hypertension of the newborn

2021 ◽  
Author(s):  
Molly K Ball ◽  
Ruth Seabrook ◽  
Elizabeth M Bonachea ◽  
Bernadette Chen ◽  
Omid Fathi ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Neonatal Intensive Care ◽  
Best Practice ◽  
Clinical Care ◽  
Persistent Pulmonary Hypertension ◽  
High Morbidity ◽  
Evidence Based ◽  
Extensive Literature ◽  
Disciplinary Expertise ◽  
Evidence Based Guidelines

Persistent pulmonary hypertension of the newborn, or PPHN, represents a challenging condition associated with high morbidity and mortality. Management is complicated by complex pathophysiology and limited neonatal specific evidence-based literature, leading to a lack of universal contemporary clinical guidelines for the care of these patients. To address this need and to provide consistent high-quality clinical care for this challenging population in our neonatal intensive care unit, we sought to develop a comprehensive clinical guideline for the acute stabilization and management of neonates with PPHN. Utilizing cross-disciplinary expertise and incorporating an extensive literature search to guide best practice, we present an approachable, pragmatic, and clinically relevant guide for the bedside management of acute PPHN.

Contrast-Induced Nephropathy: Pathophysiology and Preventive Strategies

2013 ◽  
Vol 33 (1) ◽  
pp. 37-46 ◽  
Author(s):  
Ann L. Jorgensen
Keyword(s):  
At Risk ◽  
Oxygen Free Radicals ◽  
Renal Perfusion ◽  
Evidence Based ◽  
Preventive Strategies ◽  
Prevention Strategies ◽  
Contrast Induced Nephropathy ◽  
Patients At Risk ◽  
Flow Through ◽  
Hospital Acquired

Contrast-induced nephropathy is the third most common cause of hospital-acquired renal failure, after decreased renal perfusion and nephrotoxic medications. Identification of patients at risk and implementation of preventive strategies can decrease the incidence of this nephropathy. Prevention strategies focus on counteracting vasoconstriction, enhancing blood flow through the nephron, and providing protection against injury by oxygen free radicals. Knowledge of the adverse effects associated with infusion of contrast media, identification of patients at risk for contrast-induced nephropathy, and application of evidence-based prevention strategies allow nurses to assist in the prevention of contrast-induced nephropathy.

The Promotion and Implementation of Exercise is Medicine® in Kinesiology

2020 ◽  
Vol 9 (4) ◽  
pp. 319-323 ◽  
Author(s):  
Carena Winters
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Chronic Disease ◽  
Health Care Professionals ◽  
Clinical Care ◽  
Evidence Based ◽  
Physical Activity Assessment ◽  
Activity Assessment ◽  
Exercise Referral

Evidence supporting exercise as a medicine in the prevention and management of chronic disease is indisputable. Created in 2007, Exercise is Medicine® (EIM) aims to make physical activity assessment and promotion a standard in clinical care, connecting health care professionals with qualified exercise professionals to provide evidence-based physical activity resources and programs to everyone of all abilities. Opportunities exist for exercise professionals in several areas within EIM, including exercise referral and prescription, EIM on Campus, and physical activity and EIM education. Connections between EIM and kinesiology and the need for exercise professionals to contribute to the EIM evidence are discussed.

Sign in / Sign up

Export Citation Format

Share Document