Aim: To examine the existing literature relating to the impact that interruptions have during medication administration within the paediatric critical care (PCC) setting.Background: Medication administration has inherent risks and errors can have enormous impact on the quality and efficiency of patient care, particularly in relation to experience, outcomes and safety.Nurses are pivotal to the medication administration process and therefore must demonstrate safe and reliable practice. However, interruptions can lead to mistakes and omissions.Search strategy: Key terms identified from background literature were used to search three electronic databases (Medline, CINHAL and BNI). Selected sources were critically appraised using the Critical Appraisal Skills Programme (CASP) Tool. Conclusions: This review summarizes debates within the international arena concerning the impact of interruptions to medication administration. However, conclusions drawn appear applicable in relation to practice, education and future research to other critical care settings.Relevance to clinical practice: Findings infer that no single strategy is likely to improve the negative affect of interruptions without a patient safety-focussed culture. Practice education to improve team building interactions is required that equips nurses with the skills in managing interruptions and delegating high priority secondary tasks.
This article presents a theoretical rationale for using the Internet to conduct persuasive public health interventions. Through an examination of the conceptual bases of persuasion, it is posited that the World Wide Web and other Internet-based resources have many of the characteristics necessary for persuasive communication and may, in fact, constitute a hybrid channel that combines the positive attributes of interpersonal and mass communication. The notion that the Internet features many of the persuasive qualities of interpersonal communication makes it a prime candidate for the application of key behavioral science theories and principles to promote healthier behaviors. The broad reach that the Internet shares with many mass communication channels indicates an economy to Internet-based efforts to communicate with large audiences. It is concluded that if the Internet can be used for persuasive health communication and its reach continues to expand, it is time for public health professionals to explore the design and evaluation of Internet-based interventions directed at health behavior change.
ABSTRACT:We describe the new technology add-on payment (NTAP) program used by the Centers for Medicare and Medicaid Services (CMS) to provide additional payment for breakthrough technologies in the Medicare hospital inpatient prospective payment system (IPPS). We also evaluate spending under the program. Our findings suggest that the criteria established by the CMS to limit qualifying technologies, combined with an improvement in overall payment adequacy for the new technologies that qualify for NTAPs, may represent important steps toward improving value in Medicare. [Health Affairs 27, no. 6 (2008): 1632-1641 10.1377/hlthaff.27.6.1632 S i n c e t h e i n c e p t i o n o f t h e inpatient prospective payment system (IPPS), it has been a challenge to maintain a payment and classification system that accounts for new technologies. 1 Under the IPPS, Medicare pays hospitals a fixed, prospectively determined amount for each inpatient hospitalization based on Medicare severity diagnosis-related groups (MS-DRGs). Each MS-DRG has a payment weight assigned to it, based on the average resources used to treat Medicare patients in that MS-DRG. These fixed, prospective payments encourage hospitals to operate efficiently but also put hospitals at risk for higher costs associated with changes in technology, since new technologies are typically introduced without adjustments to the payment levels. 2 (Conversely, hospitals are in a beneficial position when changes in technology result in lower costs.) Breakthrough medical technologies whose benefits are realized over a period of months or years can be a particular concern because adoption of the innovation might be in the public interest, but the full incremental cost might be incurred during the
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