scholarly journals Insulin Bolus Calculator in a Pediatric Hospital

2017 ◽  
Vol 08 (02) ◽  
pp. 529-540 ◽  
Author(s):  
Mohammad Ateya ◽  
Ranjit Aiyagari ◽  
Colleen Moran ◽  
Kanakadurga Singer
Keyword(s):  
User Satisfaction ◽  
Bolus Dose ◽  
Improve Patient Care ◽  
Severe Hypoglycemia ◽  
Pediatric Hospital ◽  
User Perceptions ◽  
Hospital Safety ◽  
Survey Responses ◽  
Improve Patient

Summary Background: Insulin dosing in hospitalized pediatric patients is challenging and requires dosing to be matched with the specific clinical and nutritional circumstances. We implemented a customized subcutaneous insulin bolus dose calculator tool integrated with the electronic health record to improve patient care. Here we describe this tool, its utilization and safety, and assess user satisfaction and perceptions of the tool. Methods: Blood glucose results for all patients who received insulin with and without the calculator tool were compared to assess safety. To assess user perceptions and satisfaction, a survey was sent to all identified users who interacted with the tool during the period from May 2015 to the end of November 2015. Survey responses were summarized, mean user satisfaction calculated, and correlation of Likert scale items with overall satisfaction assessed. Results: Hypoglycemia rates (2.2% and 2.9%, p = 0.17) and severe hypoglycemia rates (0.04% and 0.1%, p = 0.21) were similar for the groups that received insulin with and without the calculator tool. Overall satisfaction for all survey respondents was high (4.05, SD = 0.83). Physicians indicated a slightly higher satisfaction than nurses (4.33 versus 3.94, p = 0.04). User agreement with improvement of quality of care showed the highest correlation with overall satisfaction (r = 0.80, 95% CI 0.7 –0.87). Conclusion: Implementation of an insulin calculator tool streamlined ordering and administration of insulin in a pediatric academic institution while maintaining patient safety. Users indicated high overall satisfaction with the tool. Citation: Ateya MB, Aiyagari R, Moran C, Singer K. .:Insulin bolus calculator in a pediatric hospital: Safety and user perceptions. Appl Clin Inform 2017; 8: 529–540 https://doi.org/10.4338/ACI-2016-11-RA-0187

Analytical Methods for the Determination of Sartans in Pharmaceutical Formulations and Biological Fluids: A Review

2020 ◽  
Vol 16 (3) ◽  
pp. 208-222
Author(s):  
Miglena Smerikarova ◽  
Stanislav Bozhanov ◽  
Vania Maslarska
Keyword(s):  
Biological Fluids ◽  
Pharmaceutical Preparations ◽  
Improve Patient Care ◽  
Pharmaceutical Formulations ◽  
Treatment Of Hypertension ◽  
Therapeutic Doses ◽  
Reliable Methods ◽  
Improve Patient

Background: Sartans are mostly used as a part of combination with additional medicines in the therapy of essencial hypertension. Preferred combinations are ARB and thiazide diuretics (Hydrochlorothiazide (HCT) and Chlorthalidone (CHL)) or ARB and calcium antagonists. The number of sartans mostly prescribed by specialists is only seven - Candesartan (CDS), Eprosartan (EPS), Irbesartan (IBS), Losartan (LOS), Olmesartan (OMS), Telmisartan (TMS) and Valsartan (VLS). Methods: The widespread use of sartans in the treatment of hypertension requires reliable methods of analysis. Bulk drugs and pharmaceutical preparations should be analyzed to ensure the quality of the medicinal products reaching patients. On the other hand, the analysis of drugs in biological fluids aims to trace and improve patient care by adjusting the therapeutic doses of drugs. According to our knowledge, a review devoted to the analysis of sartans was published in 2014. Results: Spectral methods are widely used in the analysis of bulk drugs and pharmaceutical dosage forms due to their relatively simple procedures, low reagent and sample consumption, speed, precision and accuracy combined with accessibility and comparatively low cost of common apparatus. Many papers for determination of sartans in bulk drugs and pharmaceutical preparations based on liquid chromatographic techniques were published in the available literature. Among these methods, HPLC takes the leading place but UPLC and HPTLC are also present. Conclusion: The widespread use of sartans in the treatment of hypertension requires reliable methods of analysis. Bulk drugs and pharmaceutical preparations should be analyzed to ensure the quality of the medicinal products reaching patients. On the other hand, the analysis of drugs in biological fluids aims to trace and improve patient care by adjusting the therapeutic doses of drugs. Since 2014, many articles have been published on the sartans analysis and this provoked our interest to summarize the latest applications in the analysis of sartans in pharmaceutical formulations and biological media. Articles published from 2014 to 2018 are covered.

Combined Regenerative Approach for a Complex Lower Extremity Wound: A Case Report

2021 ◽  
Vol 33 (5) ◽  
pp. E34-E38
Author(s):  
Pedro Piccinini ◽  
Mariana de Sousa Rebelato ◽  
Marwan Masri ◽  
Carlos Uebel ◽  
Rubem Stümpfle ◽  
...  
Keyword(s):  
Negative Pressure Wound Therapy ◽  
Improve Patient Care ◽  
Acellular Dermal Matrix ◽  
Dermal Matrix ◽  
Plantar Ulcer ◽  
Regenerative Approach ◽  
Lower Extremity Wound ◽  
Acellular Dermal ◽  
Improve Patient

More than 400 million patients worldwide are affected by diabetes; over their lifetime, at least 25% will develop foot ulcers that often result in high rates of nonhealing wounds and amputation. The authors present the case of a 43-year-old female patient with multiple comorbidities who presented with a large (8 cm x 4 cm), noninfected, hindfoot plantar ulcer that extended down to the bone and calcaneus. Over 2 weeks, the patient was successfully treated using a combination of an acellular dermal matrix, nanofat grafting, and negative pressure wound therapy, lessening the effects of the ulcer on the patient’s quality of life and achieving limb salvage. Utilizing the regenerative procedures described herein may improve patient care and decrease costs.

Know the score: management of patients with a new diagnosis of acute pulmonary embolism

2020 ◽  
Vol 81 (11) ◽  
pp. 1-4
Author(s):  
D'Marieanne Koomson ◽  
Neil Smith ◽  
Simon McPherson ◽  
Vivek Srivastava
Keyword(s):  
Patient Outcome ◽  
Pulmonary Embolism ◽  
Quality Of Care ◽  
Patient Care ◽  
Acute Pulmonary Embolism ◽  
Improve Patient Care ◽  
Confidential Enquiry ◽  
New Diagnosis ◽  
Improve Patient

The National Confidential Enquiry into Patient Outcome and Death review into the quality of care provided to UK patients with a new diagnosis of acute pulmonary embolism highlights both clinical and organisational changes that should be made to improve patient care and outcomes.

scholarly journals Improving the quality of healthcare data through information design

2017 ◽  
Vol 23 (1) ◽  
pp. 104-122 ◽  
Author(s):  
Guillermina Noël ◽  
Janet Joy ◽  
Carmen Dyck
Keyword(s):  
Patient Care ◽  
Healthcare Providers ◽  
Improve Patient Care ◽  
Quality Of Healthcare ◽  
Healthcare Data ◽  
Advantages And Disadvantages ◽  
Quality Of Patient Care ◽  
Improve Patient ◽  
Insight Into

Improving the quality of patient care, generally referred to as Quality Improvement (QI), is a constant mission of healthcare. Although QI initiatives take many forms, these typically involve collecting data to measure whether changes to procedures have been made as planned, and whether those changes have achieved the expected outcomes. In principle, such data are used to measure the success of a QI initiative and make further changes if needed. In practice, however, many QI data reports provide only limited insight into changes that could improve patient care. Redesigning standard approaches to QI data can help close the gap between current norms and the potential of QI data to improve patient care. This paper describes our study of QI data needs among healthcare providers and managers at Vancouver Coastal Health, a regional health system in Canada. We present an overview of challenges faced by healthcare providers around QI data collection and visualization, and illustrate the advantages and disadvantages of different visualizations. At present, user– centred and evidence–based design is practically unknown in healthcare QI, and thus offers an important new contribution.

scholarly journals It's a Non-Dialysis Day… Do You Know How Your Patient Is Doing? A Case for Research into Interdialytic Activity

2015 ◽  
Vol 39 (1-3) ◽  
pp. 74-83 ◽  
Author(s):  
Melissa Mendoza ◽  
Maggie Han ◽  
Anna Meyring-Wösten ◽  
Kenneth Wilund ◽  
Peter Kotanko
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Standard Method ◽  
Healthcare Workers ◽  
Improve Patient Care ◽  
Know How ◽  
Tracking Devices ◽  
The Relationship ◽  
Improve Patient

Hemodialysis (HD) patients are less active than their healthy counterparts; this is associated with higher mortality. Healthcare workers observe their patients only during HD, which accounts for about 7% of the week. Knowing more about what occurs in between sessions, particularly with respect to physical activity, may improve patient care and prognosis. Yet without a standard method to measure interdialytic activity, it is difficult to compare the effect of interventions. However, it is unclear how interdialytic activity can be accurately measured. Since activity associated with quality of life is multi-dimensional, objective and subjective tools should be used in conjunction. While commercially available tracking devices can be seamlessly incorporated into everyday life and can increase awareness of user's activity, their validation is needed in the HD population. Fertile topics for research should include the relationship between objective and subjective measures in HD patients, and the investigation of physical activity in non-ambulatory HD patients.

scholarly journals 271 Introducing a ‘Do Not Attempt CPR’ and ‘Treatment Escalation Plan’ Form to Improve Patient Care and Decision Making

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Hannah O'Keeffe ◽  
Hannah Smyth ◽  
Nora Al-Shawee ◽  
Asya Tacheva ◽  
Maeve Bradley ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Improve Patient Care ◽  
Out Of Hours ◽  
Obstetrics And Gynaecology ◽  
Inappropriate Care ◽  
The Individual ◽  
Treatment Escalation ◽  
Improve Patient ◽  
Hospital Group

Abstract Background The HSE National Consent Policy recommends health care professionals ‘develop specific mechanisms for the documentation and dissemination of decisions relating to resuscitation’. We also felt a need to promote a move away from a unidimensional CPR focus more towards documentation of appropriate and inappropriate care for the individual patient. Methods In December 2018 we conducted a baseline study of the quality of documentation of patient resuscitation and escalation plans in our hospital. We reviewed the charts of patients on 4 wards on a single day. Results Of 80 patients, 19 had some documentation regarding a CPR discussion. Of those 19 one had been determined at time of an arrest call and one at the time of a deterioration. Only 13 of 19 had some documentation of a discussion surrounding the decision. Only 5 had any documentation of the reasoning behind the decision. Conclusion Other hospitals in our hospital group had implemented a `Do Not Attempt CPR' and Treatment Escalation Plan form in the last year. With their permission we used their form as a template to develop a form for use across our hospital .This form is to be readily accessible in an emergency and out of hours, and contains quality information regarding the goals of care for an individual patient. The form is a single page, easily identifiable with a red border and filed inside the front cover of the chart. We have had the form approved by our Lead Clinicians forum and Hospital’s Resus Committee. To promote the successful introduction of the form we have conducted education sessions across the departments of Medicine, Surgery, Anaesthesia and Obstetrics and Gynaecology. The form has is currently being printed and will be implemented in the coming weeks. We will be closely liaising with users and reviewing its use following implementation.

scholarly journals A community integrated respiratory team can improve patient care, quality of life and reduce hospital stays

2016 ◽  
Vol 16 (Suppl 3) ◽  
pp. s33-s33
Author(s):  
Michael Apps ◽  
Jan Minter ◽  
James Whitfield ◽  
Sue Field ◽  
Ronni Pearce ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Care ◽  
Improve Patient Care ◽  
Care Quality ◽  
Patient Care Quality ◽  
Hospital Stays ◽  
Improve Patient

scholarly journals Incorporating palliative care principles to improve patient care and quality of life in urologic oncology

2021 ◽  
Author(s):  
Lee A. Hugar ◽  
Elizabeth M. Wulff-Burchfield ◽  
Gary S. Winzelberg ◽  
Bruce L. Jacobs ◽  
Benjamin J. Davies
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Patient Care ◽  
Improve Patient Care ◽  
Urologic Oncology ◽  
Improve Patient

scholarly journals Patient and caregiver perspectives on a tool to identify undiagnosed dementia: A qualitative study

2021 ◽  
Author(s):  
Lorella Palazzo ◽  
Clarissa Hsu ◽  
Deborah Barnes ◽  
Marlaine Figueroa-Gray ◽  
Mikael Anne Greenwood-Hickman ◽  
...  
Keyword(s):  
At Risk ◽  
Treatment Options ◽  
Improve Patient Care ◽  
Dementia Diagnosis ◽  
Kaiser Permanente ◽  
Team Members ◽  
Dementia Risk ◽  
Patients At Risk ◽  
Improve Patient

Abstract BACKGROUND Early detection of dementia may improve patient care and quality of life, yet as many as half of patients are undiagnosed. Electronic health record (EHR) data could potentially be used to help to identify patients at risk of having undiagnosed dementia who could be targeted for outreach and assessment, but acceptability to patients and caregivers is unknown. METHOD We conducted five focus groups at Kaiser Permanente Washington, an integrated healthcare system in Washington State, to explore feelings about timing of dementia diagnosis, use of EHR-33 based tools to predict risk of undiagnosed dementia, and communication about risk. Two team members analyzed transcripts using inductive thematic coding. RESULTS Participant groups included: patients with dementia or mild cognitive impairment, patients with neither diagnosis, and caregivers. People who were non-white or Hispanic were oversampled. Forty patients and caregivers (63% women; 59% non-white/Hispanic) participated in focus 39 groups. Participants supported early diagnosis, describing benefits such as time to adjust to the disease, plan, involve caregivers, and identify resources. They also acknowledged the possible psychosocial toll of receiving the diagnosis. Participants also supported use of an EHR-based tool, but some worried about accuracy and privacy. Participants emphasized that information about dementia risk should be communicated thoughtfully by a trusted provider and should include advice about prognosis, treatment options and other resources. CONCLUSION Overall, patients and caregivers supported using EHR-based tools to help identify patients at risk of having undiagnosed dementia. Such tools must be implemented carefully to address concerns and ensure patients and caregivers are adequately supported.

scholarly journals Evaluasi Kepuasan Pengguna terhadap Sistem Informasi Provisioning Monitor Indihome Dunsanak (SIMIDUN) menggunakan Metode Service Quality (Studi Kasus di Telkom Witel Sumbar)

2020 ◽  
Author(s):  
Devi Gusmita ◽  
Yuhandri Yunus
Keyword(s):  
Information System ◽  
Information Systems ◽  
Service Quality ◽  
Data Processing ◽  
User Satisfaction ◽  
Quality Of Information ◽  
User Perceptions ◽  
User Expectations ◽  
Cartesian Diagram

Measurement of the quality of information systems is necessary to evaluate the satisfaction of users of the system as a consideration for companies to develop the information system. This research aims to apply and test the Service Quality method to measure the level of user satisfaction with the Indihome Dunsanak Information System Provisioning Monitor (SIMIDUN) to serve as a benchmark for system developers to develop Indihome Dunsanak's Information System Provisioning Minitor. The data used in this study is data about the details of items or indicators contained in the application to be evaluated, by distributing questionnaires to system users. Data processing is done using the Service Quality method, then the data is processed by calculating the perception value and the expected value based on the questionnaire that has been distributed then calculating the gap score to make a cartesian diagram. The results obtained in the evaluation of user satisfaction information system provisioning indihome dunsanak based on Distribution and Percentage of User Perceptions of the information system that 38.47% of SIMIDUN Information System users are satisfied with the performance of the system and only 18.47% of users assess the performance of the SIMIDUN Information System very much. satisfactory, based on the data obtained that the average servqual score is -0.97 means that the score gap between user expectations and what the user feels is negative. This means that the average expectation of new users is fulfilled by SIMIDUN Information System with a score of 0,97.

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