and the ease of work with the medication administration process after implementation of a bedside bar-coded medication administration system and a medication dispensing system in an intensive care unit (ICU) at a tertiary hospital. METHODS: A prospective cohort study was conducted to compare medication administration time before and after these two interventions using a pre-validated instrument. The bedside bar-coded medication administration system was implemented in 2008 and the medication dispensing system was implemented in 2009. Perception of nurses regarding timeliness of completion, documentation burden, administration burden, and ease of detection of medication errors during the medication administration process were measured using a 5 point Likert scale -from 1 (Strongly Disagree) to 5 (Strongly Agree). Descriptive and comparative (t test) analyses were conducted using SAS 9.2® to evaluate the impact of technological intervention on the nurses' perception. RESULTS: A total of 99 pre-intervention and 109 post-intervention responses were recorded for every medication administration process. Mean (Ϯ SD) perception score regarding timeliness of completion has been significantly (pϽ0.05) reduced from the pre-intervention period (2.8 Ϯ2.1) to the post intervention period (1.6Ϯ2.2). Similarly, mean scores for documentation (pre: 3.2Ϯ1.9 vs. post: 1.6Ϯ2.2) and administration (pre: 2.8Ϯ2.2 vs. post: 1.6Ϯ2.2) burden also improved significantly (pϽ0.05) after the intervention. There was no significant change in the perception score regarding ease of detection of medication errors (pre: 2.3Ϯ2.3 vs. post: 1.7Ϯ2.3). CONCLUSIONS: Nurses perceived less documentation and administration burden after the implementation of the technological intervention. These opinions help validate the role of health technology assessment in improving performance.
OBJECTIVES:To evaluate the current national trends in Vitamin D prescribing among the elderly seeking care in office-based physician provider settings. METHODS: Cross-sectional study was conducted using the National Ambulatory Medical Care Survey (NAMCS) data from 2000 to 2009. All ambulatory office visits made by the elderly aged Ն65 years of age were included in the study. Bivariate associations between vitamin D and study variables such as patient demographics, region, physician's specialty, insurance status, and osteoporosis diagnosis were evaluated using chi square tests. Logistic regression analyses were conducted to determine the predictive factors associated with a vitamin D. All analyses were performed with SAS statistical software, version 9.1, at an alpha of 0.05. RESULTS: Of the 279,819 office-based physician visits made by the NAMCS participants from 2000 through 2009, there were 74,904(26.7%) visits that met the inclusion criteria. This estimate represented 2.4 billion physician-office visits from the elderly in the United States during the 10-year period. Of the included visits, 1,112 (1.91%) were associated with a vitamin D. Race was a significant predictor in bot...
IntroductionPatient involvement (PI) has become a key priority to the Spanish Network of Agencies for Assessing National Health System Technologies and Performance (RedETS). As part of the national strategy to promote PI, an interest group was created in 2017 to share knowledge, develop methodologies and standardize PI processes. The aim of this work is to analyze the main activities of the Patient Interest Group 5 years after its launch and to reflect on possible needs and challenges.MethodsNarrative description and an in-depth analysis of the main activities of the Interest Group from 2017 to the present.ResultsThe group is composed of HTA researchers from the 8 regional agencies in Spain and is supported by the Ministry of Health and the RedETS council. It currently has the participation of 26 researchers, organized into different working subgroups. The initial lines of work were the analysis of the situation, the development of procedures, and the initiation of training materials for patients on HTA. At present, the main projects are the development of metrics for evaluating the impact of patient participation, the development of procedural materials to promote methodological process standardizaton (e.g., a flowchart with the main process steps, checklists, templates), and the design and piloting of virtual training for patients in HTA. New lines include the analysis of the ethical challenges of PI and the feasibility of setting up an HTA patient registration system and a patient forum to facilitate participation. In addition, the interest group has promoted the exchange of relevant information for PI and the organization of capacity building activities.ConclusionsThe RedETS Patient Interest Group is encouraging the development of activities, reflection on collective experiences, and tools that facilitate PI in Spain. Among the main challenges are the need to ensure the quality and applicability of PI and to analyze the views of patients who have actively participated in HTAs.
El objetivo del estudio fue explorar las percepciones sobre la estrategia de Atención Integrada a las Enfermedades Prevalentes en la Infancia (AIEPI) de gestores de salud y facilitadores de la estrategia. Se realizó una investigación de tipo cualitativo mediante entrevistas semiestructuradas. Se llevaron a cabo 14 entrevistas entre mayo y junio del 2011, ocho en el Estado de Ceará-Brasil y seis en el Perú. En general los profesionales manifestaron una buena percepción de la estrategia AIEPI, observándose una predominancia del componente clínico, en comparación con el componente comunitario y de servicios de salud. A diferencia de Brasil, en el Perú hubo una promoción gubernamental para la adopción estrategia. En conclusión, este estudio muestra una intervención compleja de la estrategia AIEPI, con predominancia del componente clínico poniendo en evidencia las limitaciones en la integración de los componentes de la estrategia.
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