Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Preprint”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources
PubMed1998

Influence of a critical path management tool in the treatment of acute myocardial infarction. Clinical Quality Improvement Network Investigators.

OBJECTIVE: The primary objective of this study was to determine the effect of implementing a critical path on use of proven efficacious therapies and outcomes in patients admitted to a hospital with acute myocardial infarction (AMI). The secondary objectives were to evaluate the use of unproven medications and to develop an understanding of the factors associated with adverse in-hospital outcomes in these patients. STUDY DESIGN: A nonrandomized before-after study design was used to evaluate the efficacy of a critical path instrument in patients admitted to hospital with AMI. PATIENTS AND METHODS: Consecutive patients admitted with AMI in nine participating hospitals were enrolled in the study. The critical path instrument consisted of a locally developed, preprinted physician order form. Practice patterns were determined before (n = 2305) and after (n = 2349) implementation of the critical path by primary chart review. Multivariate analysis of risk factors for mortality was performed on a combined database of 6088 AMI patients. RESULTS: The use of acetylsalicylic acid (ASA), nitrates, and beta blockers increased significantly by 3%, 2%, and 9%, respectively, after implementation of the critical path. Use of thrombolytics remained stable at 41%, and calcium channel blocker use decreased significantly by 8%. In-hospital mortality decreased by 1%. There was less use of ASA, nitrates, beta blockers, and thrombolytic therapy in women and the elderly. Multivariate analysis showed that advanced age was associated with increased mortality risk, whereas ASA, beta blockers, nitrates, and calcium channel blockers were associated with reduced mortality risk. CONCLUSION: Implementation of a critical path resulted in increased use of proven efficacious therapies, reduced use of noneffective therapy, and a trend toward reduced mortality.

Adrenergic beta-Antagonists↗
PubMed1981

Effect of label format on information recall in patients receiving prescription medications.

Many patients receive their filled prescriptions without verbal instructions and must rely on the label as their only source of information. A two-phase study was designed to measure differences in recall information when two common variations in label format were employed. Phase I: Does the patient comprehend label directions better if numbers are typed as words or as numerals? Phase II: Does the addition of preprinted auxiliary labels affect recall of directions? In Phase I, 100 patients were asked to read a label expressing three numbers as words and an additional 100 read the same label using numerals. In Phase II, patients saw the label using numerals with either zero, one, two, or three auxiliary labels attached. Each label was seen by 50 patients. Patients were scored on a point system based on their ability to repeat label directions. There was no significant difference in information recall between label format groups (p greater than 0.05). Only 44% of the patients could remember all directions, 13% could remember no information, and 63% failed to read the auxiliary labels. These results suggest that pharmacists should place less reliance on label format and the use of auxiliary labels to communicate information and spend more time verbally counseling their patients on the proper use of their medications.

Drug Labeling↗
PubMed1988

Total parenteral nutrition: a concurrent drug utilization review.

University Hospital, a 428-bed tertiary care teaching hospital, treats approximately 150 patients annually with TPN. Currently used are three standard TPN base formulae which are ordered by physicians using preprinted TPN order forms. A concurrent Drug Utilization Review (DUR) was conducted on TPN treatment of 30 patients, to examine adherence to the current TPN protocol. Criteria for evaluation included ruling out enteral feeding, indications for TPN use, duration of therapy, monitoring of laboratory values, and caloric delivery. Physician and dietician estimation of caloric needs were compared to calories actually ordered by the physician. The number of pharmacist interventions and TPN bags wasted were also determined. Results could not be obtained with respect to ruling out enteral feeding and indications for TPN therapy due to inadequate information. The five-day minimum for duration of TPN therapy established in the DUR criteria was not attained in 23 percent (7/30) of patients. Seventy-seven percent of laboratory monitoring tests were completed. Results indicate wide disparities in caloric calculation and delivery; only 45 percent (10/22) of the patients who were ordered TPN met the physician's caloric goal. A number of recommendations were made to improve the TPN protocol and TPN therapy.

Adult↗
PubMed1988

Controlling pharmacy costs.

There are many costs associated with parenteral nutrition: physician time, nursing time, biochemical monitoring, patient education, ancillary equipment and the nutrition solutions themselves. The solutions are easily identified as responsible for a large proportion of these costs. There are several strategies that can be used to help control pharmacy costs, such as selection of ingredients, purchasing contracts, standardized formulae and prescribing procedures, preprinted doctor's order forms, automated manufacturing and labelling processes, patient monitoring, all-in-one preparation, and contracted manufacturing services. Individual pharmacies need to know what options are available in order to select those that, in the context of their own institutions, can lead to cost savings and improved efficiency.

Canada↗
PubMed1999

CMs fight for acceptance of premature infant path.

Responding to benchmarking data indicating that their length of stay for premature infants was above the national average, case managers at University Hospital-University of Colorado Health Sciences Center in Denver formed a multidisciplinary team to develop a pathway designed to address the problem. But they encountered stiff initial resistance from both staff nurses and physicians, many of whom regarded the pathway as "cookbook medicine." The main appeal to nurses was that the pathway's preprinted orders would help standardize care--a key selling point at this teaching hospital, where attending physicians and interns rotate in and out on a monthly basis. Case managers also changed the pathway's documentation requirements at the suggestion of the nurses, adopting a charting-by-exception approach. Physicians have been slower to come around, but the case managers are optimistic that outcomes data on the revised pathway, due within six months, will demonstrate the pathway's benefits.

Attitude of Health Personnel↗
PubMed1999

The clinical characteristics of brown recluse spider bites treated by family physicians: an OKPRN Study. Oklahoma Physicians Research Network.

BACKGROUND: The brown recluse spider (Loxosceles reclusa) has been recognized as a cause of necrotizing bites since at least 1957, but most of the literature consists of laboratory studies using animals, human sera, or case reports of more dramatic examples of bite reactions. Our goal was to develop a more comprehensive clinical description of the brown recluse spider bites treated by family physicians. METHODS: Two preprinted, postage-paid cards were given to physician members of the Oklahoma Physicians Research Network. One card was used for recording examination and treatment data, and the other was for tracking the progress of the bite until it was completely healed. For comparison, similar information was collected from the local poison control center. RESULTS: From April 1996 to August 1998, the physicians recorded 149 bites. Most of the victims were women aged 18 to 65 years, and most sought treatment within 3 days. Pain was common but not universal. Most bites were located on the extremities. Erythema was always present, but necrosis was present in only 40% of the bites. Some systemic signs or symptoms were common. The most frequent forms of treatment were systemic antibiotics (66% of cases) and conservative wound management (56%). Only 1 hospitalization occurred; 43% of the bites healed within 2 weeks; and only 13% resulted in scarring. CONCLUSIONS: The brown recluse spider bite is a relatively common problem treated by family physicians in Oklahoma. Most bites are not serious. More research at the practice level is needed to develop diagnostic criteria and to explore the effectiveness of various treatment options.

Adolescent↗
PubMed1999

How case managers can help reduce medical errors.

Although mistakes are inevitable, even in the best-run organizations, the tools used for care coordination--such as clinical pathways, standing order sets, algorithms, and other "point of care" reminders--are among the most important weapons in the fight against medical errors in hospitals. For example, establish maximum doses for high-risk drugs, and incorporate these criteria into pathways or standing orders. Preprinted order sets and protocols allow staff to focus their attention on relevant patient care issues, rather than spending time rewriting orders and possibly introducing errors into the system. Case managers can be particularly effective in helping other caregivers catch and correct mistakes before the patient is harmed.

Case Management↗
PubMed1999

CABG path cuts recovery LOS to one post-op day.

An early goal of the cardiac service line team at St. Francis Hospital and Health Centers in Beech Grove, IN, was to reduce the postoperative recovery time of coronary artery bypass graft patients in the Cardiac Surgery Unit (CSU). Previously, recovery time had averaged two to three days, while the room rate in the CSU runs about $1,200 per day. Now, with the help of a pathway originally based on existing preprinted orders created by the cardiac surgeons, the service line has decreased recovery length of stay to one day, with 80% to 90% of patients moving out on postoperative day one. Eventually, the cardiac line staff hope to combine the recovery area and the stepdown unit so it's not necessary to transfer patients and maintain two separate staffs.

Coronary Artery Bypass↗
PubMed1999

Small hospitals benefit from program investments.

Hospitals with fewer than 100 beds may find it challenging to get a return on clinical paths or case management program investments. That is why it so important to consider the hospital's managed care goals before embarking on the development of any program designed to improve care coordination. To achieve these goals, the small hospital has several different action plan choices, including: improve preadmission planning, more closely monitor the appropriateness of admissions and continued stays, expand discharge planning, design preprinted physicians' orders or protocols, expand community health services, and expand community-based case management. Most importantly, involvement is needed from physicians, managers, and staff who "own" the clinical process involved.

Budgets↗
PubMed2000

Validity of clinical use of the clock-drawing test in Thai elderly patients with memory problems.

Forty eight elderly Thai patients, 12 demented, 36 non-demented who consecutively attended a geriatric clinic, at Chulalongkorn University Hospital, with a memory problem were recruited in the study which aimed to determine the validity of the clock-drawing test (CDT) and Chula mental test (CMT). Subjects took the Chula Mental Test (CMT) and were asked to draw a clock on a preprinted 12 centimeters circle showing the time of 11:10. Clocks were scored using the Chula Clock-drawing Scoring System (CCSS). Ten subjects voluntarily participated and completed the WAIS test. The best cutoff score of the CMT and the CDT using diagnosis of dementia as a gold standard were 15 and 7 respectively. Sensitivity and specificity for detecting dementia by the CDT were 100 per cent and 94.1 per cent respectively. Sensitivity and specificity for detecting dementia by the CMT were 83.3 per cent 91.7 per cent. The likelihood ratio (95% confidence interval) of the CMT and the CDT were 10 (3.3-30.4) and 17 (4.4-65.2) respectively. There was a good correlation of the CDT score and the CMT score with the WAIS score. Although the CDT was better than the CMT in literate patients, the CDT had limitation of use among illiterate patients but not the CMT. The benefits of simultaneously application on dementia screening was shown. This study showed that the CDT was a valuable, brief method of dementia screening in elderly Thai patients with memory problems.

Aged↗
PubMed2000

The new peer review.

It is widely recognized that the Internet has fundamentally changed the dynamics of publication, and in particular, it is clear that there is no effective way to control the release of any web-based publication. The scientific and lay literature is now accessible to the public with unprecedented ease Recent proposals to start a life sciences online repository of preprints highlights the trend towards "publish first, review later" that seems to be emerging. Does this mean that the peer review process is dead? It certainly suggests that there is a need for a change in how the process works. We discuss currently available technologies to enable the implementation of new, distributed peer review process benefiting multiple user communities.

Internet↗
PubMed2000

Literacy for health information of adult patients and caregivers in a rural emergency department.

The nurse practitioner is responsible for providing the patient and family with understandable written information before discharge from the emergency department (ED) following an acute event. Patients are more likely to adhere to their treatment regimen and follow-up if they have a clear understanding of their instructions. Patients cannot correctly interpret information they cannot read. This study describes the ability of two age groups of rural ED patients or caregivers to read health information. The literacy level of 91 younger adults and 104 elderly adults from three rural hospitals was assessed at discharge with the Rapid Estimate of Adult Literacy in Medicine (REALM). While there was no difference in the REALM scores (t = 0.608) of the two age groups, there was a significant difference in the education levels. The REALM scores placed the reading level of the sample at between seventh and eighth grade. The preprinted discharge instruction forms used by the three rural hospitals had a Flesch-Kincaid grade level of 9.0, a reading level higher than 62% of the sample. By ensuring discharge instructions are developed at a reading level of sixth grade or below, nurse practitioners can provide teaching materials that encompass the reading levels of the majority of the rural ED population.

Adolescent↗
PubMedDate not supplied

Conservation and management applications of the REEF volunteer fish monitoring program.

The REEF Fish Survey Project is a volunteer fish monitoring program developed by the Reef Environmental Education Foundation (REEF). REEF volunteers collect fish distribution and abundance data using a standardized visual method during regular diving and snorkeling activities. Survey data are recorded on preprinted data sheets that are returned to REEF and optically digitized. Data are housed in a publicly accessible database on REEF's Web site (http://www.reef.org). Since the project's inception in 1993, over 40,000 surveys have been conducted in the coastal waters of North America, tropical western Atlantic, Gulf of California and Hawaii. The Fish Survey Project has been incorporated into existing monitoring programs through partnerships with government agencies, scientists, conservation organizations, and private institutions. REEF's partners benefit from the educational value and increased stewardship resulting from volunteer data collection. Applications of the data include an evaluation of fish/habitat interactions in the Florida Keys National Marine Sanctuary, the development of a multi-species trend analysis method to identify sites of management concern, assessment of the current distribution of species, status reports on fish assemblages of marine parks, and the evaluation of no-take zones in the Florida Keys. REEF's collaboration with a variety of partners, combined with the Fish Survey Project's standardized census method and database management system, has resulted in a successful citizen science monitoring program.

Animals↗
PubMed1992

An evaluation of interventions for meeting the information needs of families of critically ill patients.

OBJECTIVE: To evaluate the effectiveness of two methods of meeting the information needs of families of critically ill patients: an open visiting hour policy and a family information booklet. SETTING: Medical intensive care unit of a university medical center. SUBJECTS: Family members (N = 147) of patients admitted to the medical intensive care unit. INTERVENTIONS: Implementation of an open visiting hour policy and information booklet. MEASUREMENTS AND MAIN RESULTS: Questionnaires were distributed to family members 24 to 48 hours after the patient's admission. The questionnaire addressed family satisfaction with having specific information needs met and posed questions that tested their knowledge of unit policies and personnel. The questionnaire was distributed to three groups: families who had restricted visiting hours and no booklet (group 1, n = 48), families who had open visiting hours but no booklet (group 2, n = 50), and families who had open visiting hours and an information booklet (Group 3, n = 49). Implementation of an open visiting hour policy increased family satisfaction. Families exposed to both the open visiting hours and the information booklet were more knowledgeable about specific details than were those exposed to only the open visiting hour policy. CONCLUSIONS: Flexible visiting hours and information booklets were two practical methods of meeting the information needs of families. Open visiting hours, as a singular intervention, significantly improved family satisfaction. The effectiveness of the booklet in assisting families to recall discrete pieces of information supports the further development and use of preprinted materials to assist in meeting family information needs.

Attitude to Health↗
PubMed2004

[New international classification of headache disorders (ICHD-II)].

It has been almost 15 years since the first edition of the International Headache Classification appeared in 1988. It was widely accepted and well tolerated. However, rapid progress of the headache research is pushing for a drastic revision of the classification. The new International Classification of Headache Disorders (ICHD-II) was disclosed in September 2003 as a preprinted version and formally published in January 2004. The ICDH-II classifies headache disorders into 3 parts: the primary headache, the secondary headache and cranial neuralgia, central and primary facial pain and other headaches. Basically, the most important diagnostic criteria, those of migraine and tension-type headache, remain unchanged. Several new entities such as chronic migraine, hypnic headache, hemicrania continua, benign thunderclap headache and medication overuse headache have been added. This will encourage intensified headache researches in the future.

Headache↗
PubMed2006

Antibiotic prescribing for acute cough: the effect of perceived patient demand.

BACKGROUND: GPs decide whether or not to prescribe antibiotics for acute cough. Apart from clinical signs and symptoms, non-medical reasons influence this decision as well. AIM: To obtain a valid estimate of the effect of perceived patient demand. DESIGN OF STUDY: Secondary analysis of cluster randomised controlled trial data. SETTING: Eighty-five Flemish GPs. METHOD: GPs completed a preprinted form with medical as well as non-medical information and their prescription for 20 consecutive adult patients consulting with acute cough in the periods February to April 2000 and 2001. The effect of perceived patient demand on antibiotic prescribing was estimated by performing alternating logistic regression analysis. A hierarchical backwards elimination procedure, described by Kleinbaum, was used. RESULTS: Seventy-two GPs participated, including 1448 patients eligible for analysis; 500 (34.5%) were prescribed an antibiotic and, according to the GP, 218 (15.1%) asked for an antibiotic. In cases of perceived patient demand antibiotics were prescribed significantly more often (odds ratio [OR] = 4.64, 95% confidence interval [CI] = 2.96 to 7.26). In the final model (n = 819; OR = 4.60, 2.59 to 8.17); Hosmer-Lemeshow goodness-of-fit P = 0.72), the effect of perceived patient demand for an antibiotic depended on the outcome of the lung auscultation. When patient demand was perceived, antibiotics were prescribed significantly more often only in the case of a normal lung auscultation or in the case of only one abnormal auscultatory finding (adjusted OR = 20.83, 95% CI = 8.86 to 48.99; adjusted OR = 4.79; 95% CI = 2.16 to 10.60, respectively). CONCLUSIONS: Perceived patient demand has a significant, independent and clinically relevant effect on antibiotic prescribing for acute cough with negative findings on the lung auscultation. Practice guidelines and interventions to optimise antibiotic prescribing have to take this effect into account.

Acute Disease↗
PubMed1991

The use of printed instruction sheets to enhance patient compliance.

Printed instruction sheets can improve doctor/patient relationships. Patients can better understand physician requirements and treatment regimens when instructions are preprinted or written. Information sheets increase patient compliance and decrease malpractice claims.

Humans↗
PubMed1989

Bar-code technology for documenting administration of large-volume intravenous solutions.

The failure to properly document dispensing, administration, charging, and crediting of large-volume plain i.v. solutions in a hospital, along with the potential for using bar-code technology to reduce documentation discrepancies, was investigated. Portable bar-code scanners and preprinted bar-code labels were employed to identify large-volume plain i.v. solutions administered on two selected nursing units of a 1000-bed, private, not-for-profit hospital. Inservice training sessions were conducted to instruct hospital personnel in the use of the scanning equipment. Comparisons of patient statements and medication administration records for large-volume plain i.v. solutions established the level of documentation errors in the study hospital. The causes of these errors were traced to three primary sources: (1) failure to document administration of a solution to a patient (38%), (2) failure to credit patients for i.v. solutions returned to the pharmacy (37%), and (3) administration of a solution to a patient other than the patient for whom the solution was dispensed (25%). Accountability for large-volume plain i.v. solution charges to patients was improved by 19% using bar-code technology. The pharmacy manager desiring to employ bar-code technology should determine convenient methods for applying bar-code labels to solutions and for scanning the bar codes, as well as provide programming that can compensate for erroneous scans.

Documentation↗