Construct a Cpoe Decision Supporting and Monitoring System to Decrease Pims Used in Hospitalized Elderly Patients

Abstract

of 882 nurses aged 20 to 65 years were compared with 12,213 non-medical working women with similar socioeconomic status. Multivariate generalized estimating equation models were analyzed to test the hypotheses. We also used weighted propensity scores to adjust for selection bias. The primary outcomes were whether or not patients received hospital-based invasive procedures or surgery, total hospitalization cost, length of hospital stay (LOS), and 7-day and 14-day readmission association with genital diseases. Results: Nurses were less likely to undergo hospital-based surgery for genital diseases (OR 0.60; 95% CI: 0.44, 0.81), and they incurred lower total hospitalization cost (β -0.12; 95% CI: -0.18, -0.06) than non-medical working women after adjusting for demographic and clinical factors (eg, age, insurable wage, major diagnosis, Charlson comorbidity index, and physician and institutional characteristics). However, the likelihood of receiving hospital-based invasive procedures, longer LOS, and readmission did not differ between the two groups. ConClusions: A probability of undergoing hospitalized surgery for female genital diseases and incurring total hospitalization cost was lower among nurses than among non-medical working women. These findings suggest that medical knowledge, familiarity with health care system and care experience may have been contributory factors.objeCtives: Many studies have reported the reduction in Health Related Quality of Life among young girls before, during and after menstrual bleeding. And many of these girls also resort to medications like NSAIDs to alleviate the pain during the same. The present study was aimed to study the difference in health related quality of life among young NSAID users and non-users. Methods: In this cross sectional study a pilot tested questionnaire was used to collect information regarding college students (n= 496) with age between 18-25 years. Information such as demographics, socio-economics, medication use and pain severity was collected. For health related quality of life measurement both descriptive and visual analogue score of EQ 5D 5L questionnaire ware used. The data collected was analyzed using SPSS 16.0.0. The test of significance was done by using Mann-Whitney U test. Results: Mean age of the surveyed population was found to be 20.46±2.81 with 12.88±2.372 years as the average age of commencement of menstrual cycle. The BMI was found to be 19.89±4.88. 77.4% of students reported having some sort of pain before, during and after the menstrual bleeding. The average EQ 5D VAS score was found to be 69.05±18.62. Mann-Whitney U test has shown significant difference (p= 0.001) among the medication users for alleviation of pain whereas there was no significant difference (p= 0.72) among self-medication and prescription drug users. ConClusions: Eventhough the population studied was quite young there was a difference in health related quality of life among medication users and non-users.

Reviewing Potentially Inappropriate Medication in Hospitalized Patients Over 65 Using Explicit Criteria: A Systematic Literature Review

“… No statistical difference noted after the intervention in PIM or PPO. 3 Chu, 2014 38 Taiwan Prospective study Number of elderly patients not stated. Beers 2012 CPOE There were two interventions: one with the decision support system and the other by the clinical pharmacist using Beer’s criteria.…”

“… 27 Moreover, there was one pilot study, 36 three before-and-after studies, 28–30 four observational studies, 37 , 38–42 and nine interventional studies. 31–35 , 38 , 39 . Approximately 16,093 patients were included in the studies.…”

“…Ten studies applied explicit tools on admission, 21 , 22 , 26 , 28 , 29 , 31–33 , 35 , 40 nine studies during the hospital stay, 20 , 23 , 24 , 30 , 34 , 36 , 37 , 46 , 47 and several studies did not report the stage of hospitalization in which the HCP used the tools. 25 , 38 , 39 , 41–45 …”

“… 20 , 44 The remaining studies did not specify how the recommendations were communicated to the physician. 22 , 23 , 25 , 29 , 33 , 34 , 37 , 38 , 40 , 43 , 46–48 …”

“… 27 The lowest PIM reduction was observed in two studies in which the hospital pharmacist detected the PIM and it was sent to the attending physician. 38 , 44

Figure 4 Description of PIM reduction before and after tool implementation by HCP in hospitals.

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