Objective: In this descriptive study, we evaluated perceptions and knowledge of inpatient glycemic control among resident physicians. Methods: We performed this study at four academic medical centers: the University of Mississippi Medical Center, University of Virginia Health System, University of Louisville Health Sciences Center, and Emory University. We designed a questionnaire, and Institutional Review Board approval was granted at each institution prior to study initiation. We then administered the questionnaire to Internal Medicine and Medicine-Pediatric resident physicians. Results: A total of 246 of 438 (56.2%) eligible resident physicians completed the Inpatient Glycemic Control Questionnaire (IGCQ). Most respondents (85.4%) reported feeling comfortable treating and managing inpatient hyperglycemia, and a majority (66.3%) agreed they had received adequate education. Despite self-reported comfort with knowledge, only 51.2% of respondents could identify appropriate glycemic targets in critically ill patients. Only 45.5% correctly identified appropriate inpatient random glycemic target values in noncritically ill patients, and only 34.1% of respondents knew appropriate preprandial glycemic targets in noncritically ill patients. A small majority (54.1%) were able to identify the correct fingerstick glucose value that defines hypoglycemia. System issues were the most commonly cited barrier to successful inpatient glycemic control. Conclusion: Most respondents reported feeling comfortable managing inpatient hyperglycemia but had difficulty identifying appropriate inpatient glycemic target values. Future interventions could utilize the IGCQ as a pre- and postassessment tool and focus on early resident education along with improving system environments to aid in successful inpatient glycemic control. Abbreviations: DM = diabetes mellitus; Emory = Emory University Healthcare; IGC = inpatient glycemic control; IGCQ = Inpatient Glycemic Control Questionnaire; IRB = Institutional Review Board; PGY = postgraduate year; UMMC = University of Mississippi Medical Center; UVA = University of Virginia Health System; UL = University of Louisville Health Sciences Center
Background Uncontrolled hyperglycemia in hospitalized patients, with or without diabetes mellitus, is associated with many adverse outcomes. Resident physicians are the primary managers of inpatient glycemic control (IGC) in many academic and community medical centers; however, no validated survey tools related to their perceptions and knowledge of IGC are currently available. As identification of common barriers to successful IGC amongst resident physicians may help foster better educational interventions (ultimately leading to improvements in IGC and patient care), we sought to construct and preliminarily evaluate such a survey tool. Methods We developed the IGC questionnaire (IGCQ) by using previously published but unvalidated survey tools related to physician perspectives on inpatient glycemic control as a framework. We administered the IGCQ to a cohort of resident physicians from the University of Mississippi Medical Center, University of Louisville, Emory University, and the University of Virginia. We then used classical test theory and Rasch Partial Credit Model analyses to preliminarily evaluate and revise the IGCQ. The final survey tool contains 16 total items and three answer-choice categories for most items. Results Two hundred forty-six of 438 (56.2%) eligible resident physicians completed the IGCQ during various phases of development. Conclusions We constructed and preliminarily evaluated the IGCQ, a survey tool that may be useful for future research into resident physician perceptions and knowledge of IGC. Future studies could seek to externally validate the IGCQ and then utilize the survey tool in pre- and post-intervention assessments. Electronic supplementary material The online version of this article (10.1186/s12909-019-1657-0) contains supplementary material, which is available to authorized users.
Implantable Medical Devices (IMDs) have emerged as a break-through technology for e-healthcare. Healthcare providers use wireless medium of communication to monitor patients, perform diagnostics and download data in hospitals or from homes. This provides great convenience, flexibility, cost effectiveness and timely patient care. These implanted devices contain sensitive personal data and other health related information and are controlled through commands issued by healthcare staff wirelessly. Wireless medium of communication introduces several vulnerabilities which if exploited might have severe implications on the security, privacy and safety of patients using IMDs. In this paper we aim to discuss the security and privacy issues for wireless communication of Implantable Medical Devices and come out with a threat model. We also look into the methods proposed in literature to mitigate them and analyze their suitability. Intrusion Detection has gained importance over the years especially for wireless adhoc networks. Seeing the importance of constantly monitoring the IMD-reader communication in detecting and deterring security attacks, we propose a model called IMD-IDS to be integrated with cellphone or PDA, which people can carry with them. The IMD-IDS manages IMD keys, authenticates IMD readers, and blocks attempted accesses to the patients IMD from unauthorized readers using specification based intrusion detection. It monitors the communication between IMD-reader for detecting malicious activities and help patients to take corrective actions if need be. This research is the first effort to apply specification-based detection techniques to detect attacks in the IMD wireless communication.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.