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At least 73 records · Page 4Linked to original sources
PubMed1989

Use of concurrent monitoring and a preprinted note to modify prescribing of i.v. cimetidine and ranitidine in a teaching hospital.

The use of concurrent monitoring and an informational note to modify physician prescribing of i.v. cimetidine and ranitidine is described. The study population consisted of all patients for whom i.v. cimetidine and ranitidine therapy was prescribed by house-staff physicians at an 850-bed, tertiary-care, university-affiliated hospital during February, March, and April 1987. Phase 1 of the trial consisted of an initial drug-use review of all eligible patients receiving therapy. In phase 2, the study population was divided into an intervention group and a control group. When therapy could be changed from the i.v. to the oral or nasogastric (NG) route of administration, an informational note was placed in the chart of the patients in the intervention group. Patients in the control group were also assessed daily for the appropriateness of conversion to oral or NG therapy. The following outcome measures were used to test the effectiveness of the intervention in modifying physician prescribing: mean number of i.v. doses and days of i.v. therapy per patient and mean number of inappropriate i.v. doses and days of i.v. therapy per patient. The drug acquisition costs for both groups were also analyzed. A total of 233 patients were monitored during the study period. The percentage of patients who did not receive oral therapy as soon as possible was not significantly different between the intervention (55%) and control (58%) groups. Patients in the intervention group received three to six fewer i.v. doses than patients in the control group and three to six additional oral doses.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1982

[Possibilities and problems of patient education using preprinted forms for standard otorhinolaryngologic operations].

Since six years we have got experiences in patient's instructions by our own form-sheets concerning standard operations in the ENT-region. After having mentioned general problems of the medicolegal situation, the most important aspects of risk instruction by the 21 forms are discussed. Finally the text of all form-sheets is quoted, the final observation--identical in all sheets--is preceding. In conclusion we emphasize that especially the patient's information by form-sheets needs an additional dialogue with the patient too. The written documentation of the complete instruction is absolutely necessary as judgments show.

Humans↗
PubMedDate not supplied

A risk-specific anesthesia consent form may hinder the informed consent process.

STUDY OBJECTIVE: To evaluate the effect of a preprinted, risk-specific consent form on the amount of anesthetic risk information patients retain from the preoperative interview. DESIGN: Postoperative survey of consecutive inpatients to determine risk information retained before and after implementation of a preprinted anesthesia consent form, using standard preoperative risk discussions. SETTING: Inpatient units of a university medical center. PATIENTS: Two groups of patients, both of whom received a standard oral discussion of anesthetic risk information, were compared. Patients in the control group (125 consecutive inpatients) received this information only orally and were interviewed two weeks prior to implementation of a preprinted anesthesia consent form. Patients in the study group (92 consecutive inpatients) received this information orally and via a preprinted consent form and were interviewed between the fourth and sixth weeks after implementation of a preprinted anesthesia consent form. INTERVENTIONS: Anesthesia residents discussed five standard anesthetic risks with elective, adult inpatients (n = 233) during a two-week period immediately before and between the fourth and sixth weeks after instituting the mandatory use of a risk-specific anesthesia consent form. These patients were interviewed postoperatively by one of the authors to determine the amount of anesthesia risk information they retained. MEASUREMENTS AND MAIN RESULTS: Results of the postoperative survey showed that patients in the control group retained more information concerning anesthetic risks than did those in the study group (33% vs 19%, p less than 0.01). CONCLUSIONS: To improve the informed consent process, either a better method of presenting the preprinted, risk-specific consent form or another method of simultaneously conveying and documenting risk information is needed.

Anesthesiology↗
PubMed2004

Standardized order form for investigational drugs: effect on completeness of the prescription.

AIM: To compare completeness and quality of orders written before and after introduction of a preprinted medication order form for investigational drugs. Completeness of physician's orders for investigational drugs was compared during two successive periods: before and after implementation of a preprinted form for these orders. METHOD: Orders were checked for six elements: pharmaceutical company's identity, protocol's name, patient's identity (i.e., initials), investigator's signature, order's date, and drug designation. Each element was categorized according to three quality criteria: mistake (wrong information), omission, or imprecision (incomplete information). A total of 536 orders were evaluated corresponding to 268 orders and to 4824 quality criteria in each period. RESULTS: During the baseline study, 228 (85%) problematic prescriptions were detected. Of the 4824 quality criteria evaluated, 422 (8.7%) errors were recorded. Common types of errors were omission of pharmaceutical company's identity, mistaken protocol name, and omission of patient's identity. After the introduction of the order form, 13 (4.9%) prescriptions contained errors. Fifteen (0.3%) quality criteria were not in conformity with the standard. The common types of errors were omission of patient's identity and order date. Physician's orders for investigational drugs are more complete when they use a preprinted prescription form than when they use traditional orders. CONCLUSION: The introduction of a preprinted order form for investigational drugs prevents potential medication errors and contributes to patients' safety.

Clinical Trials as Topic↗
PubMed1999

Standardized management of intracranial pressure: a preliminary clinical trial.

OBJECTIVE: To test a standardized protocol for management of intracranial pressure (ICP) after severe head injury (i.e., traumatic brain injury), consistent with published guidelines. METHODS: We compared prospective use of a standardized protocol for ICP management in 12 patients with severe head injuries and retrospective ICP management using preprinted hospital orders in combination with ad hoc physician orders in 12 historical control patients with severe head injuries. With the standardized protocol, flow-chart decision logic diagrams were applied at patient bedside by critical care practitioners, with nursing shift review. RESULTS: ICP and its variation during the first 6 intensive care unit days was less for the standardized protocol- than for the preprinted order-managed group (p <0.001), indicating better process control with the standardized protocol. ICP exceeded 25 mm Hg for less time for the standardized protocol group (182 hours; 15+/-23 hours/patient) than for prescribed order group (429 hours; 36+/-28 hours/patient) (p = 0.03). On average, ICP exceeded 20 mm Hg for 2.3 days for the standardized protocol-managed group and for 4.7 days for the prescribed order-managed group. Cerebral perfusion pressure was significantly greater and its variation less for the standardized protocol- than for the preprinted order-managed group. Fewer interventions were made for ICP management for the standardized protocol- than for the preprinted order-managed patients (601 vs. 876), suggesting more effective nursing time using the standardized protocol. CONCLUSION: ICP management was more consistent, and intracranial hypertension was better controlled, in patients managed according to a standardized, data-driven protocol for escalation and weaning of therapies in response to immediate patient needs. We recommend computerized implementation and a randomized clinical trial to compare the protocol with prescribed orders.

Algorithms↗
PubMedDate not supplied

Peer review in a post-eprints world: a proposal.

Recently, a number of electronic biomedical preprints servers, which allow the archiving of electronic papers without prior peer review, have been established, most notably the Clinical Medicine & Health Research NetPrints website and the The Lancet's Electronic Research Archive. These mark an extension to clinical medicine and health research of a novel experiment in the provision of public access to electronic versions of preprints. However, until now the biomedical community has been slow to adopt this new form of communication. This paper discusses how the value and attractiveness of eprint servers can be improved, and how electronic preprints (eprints, NetPrints) can be evaluated. Previous studies of variations in rejection rates after conventional peer review have indicated that the extent of scholarly consensus is an important variable for acceptance. This variable seems likely also to be important in readers' and editors' evaluations of eprints. A combination of unsolicited comments together with commissioned review might yield articles of higher quality than either could accomplish alone. However, if systematically applied to all eprints, such a process would be time-consuming and labor-intensive. A sequential review process is proposed, beginning with the acceptance of a preprint by an eprint server, followed by revision on the basis of comments received publicly or privately, and by the solicitation of selected eprints for commissioned review. This sequential process could have advantages, both for the authors of articles, and for journal editors. For example, the eprint would, in effect, have been submitted simultaneously to a large number of relevant journals. Some issues about evaluative studies of the outcomes of eprint submissions are also considered briefly. It would be particularly valuable if every eprint server included access to comparative statistics on visits by readers to individual eprints.

Evaluation Studies as Topic↗
PubMedDate not supplied

Evaluation of nursing documentation of patient teaching.

The preprinted interdisciplinary care plan is an effective tool in increasing the documentation of patient teaching onto the patient education record; however, when combined with praise and chart audits, the preprinted document becomes even more effective. This study indicates that reinforcement in the form of a preprinted care plan combined with inservice education and audit increases documentation of patient education more than the use of the preprinted document alone.

California↗
PubMed2026

Artificial intelligence-derived myocardial fibrosis on cardiac magnetic resonance for prognosis in cardiomyopathy: A systematic review of a sparse evidence base.

BACKGROUND: Myocardial fibrosis on cardiovascular magnetic resonance (CMR), assessed by late gadolinium enhancement (LGE) and parametric mapping, is an established predictor of adverse events in cardiomyopathy. We assessed whether artificial intelligence (AI) quantification of fibrosis adds independent prognostic value. METHODS: We searched six databases, a clinical-trials register, and a preprint server from inception to 13 June 2026. Eligible studies used AI to generate a fibrosis marker in adults with ischemic or nonischemic cardiomyopathy, with covariate-adjusted outcomes over &#x2265;12 months. Risk of bias was assessed using PROBAST, PROBAST+AI, and QUIPS. Fewer than three comparable studies precluded meta-analysis; certainty was rated using GRADE. RESULTS: Of 448 records (381 after de-duplication), 18 full texts were reviewed and two included, one peer-reviewed and one preprint. In an ischemic-cardiomyopathy registry (Ghanbari et al.; n = 216 analytic, 26 events), AI-derived dense LGE scar predicted arrhythmic events (univariable hazard ratio [HR] 2.35, 95% CI 1.33-4.15), and AI-derived but not manual scar improved discrimination beyond guideline criteria (area under the curve 0.63 to 0.68; p = 0.02). In a nonischemic dilated-cardiomyopathy preprint (Kim et al.; n = 347, 119 events), automated extracellular volume &#x2265;30% predicted cardiovascular death or heart-failure hospitalization (adjusted HR 2.00, 95% CI 1.32-3.03). Both were at high risk of bias, with data-derived thresholds and no external validation. CONCLUSIONS: Across only two studies, AI-derived fibrosis was independently associated with adverse cardiovascular events, but its added value over manual quantification remains unproven. Certainty was very low. The evidence base is sparse and not yet ready for clinical use.

Humans↗
PubMed1984

Stability of large systems.

We use the May-Wigner Stability Theorem (Geman (1984) preprint, Brown University; Hastings (1984) preprint, Hofstra University), to study the Lyapunov and structural stability of "real" large systems. Here are our new main results. For large systems which satisfy certain natural scaling relations (Harrison, Am. Natur., 113 (1979) 659; May (1979) Blackwell Scientific, Oxford), Lyapunov stability tends to increase with increasing complexity. However, at least one aspect of structural stability decreases: both competitive and cooperative effects can rapidly destabilize such a system. Finally, we observe that random matrices which satisfy the hypotheses and stability criterion of the May-Wigner theorem are asymptotically of the form 'rotation followed by multiplication by lambda,lambda less than 1'. This allows an easy analysis of the effects of noise in these systems. We conclude by briefly discussing applications to analysis of stability of systems such as the world economy, power networks, and the immune system.

Cybernetics↗
PubMed1996

Emergency department discharge instructions and patient literacy: a problem of disparity.

This two-part study was designed to determine the reading level necessary to understand commonly used emergency department (ED) discharge instructions and the functioning reading level of adult patients treated in an urban hospital ED. In the first phase, 10 preprinted patient discharge instructions were analyzed using the Flesch Reading Ease Score. The average reading level required to comprehend these instructions was 9.8, with a range from the 8th to the 14th grade. In the second phase of the study, a reading exam, based on the Stanford Diagnostic Reading Test, was administered to 82 ED patients prospectively. The mean reading level was 9.8, with a median level of 10; approximately 45% of the ED patients would be unable to understand the preprinted discharge instructions. ED discharge instructions are frequently written at a level beyond the comprehension of a significant portion of the population.

Adolescent↗
PubMedDate not supplied

The development of a group B streptococcus prevention policy at a community hospital.

BACKGROUND AND OBJECTIVES: In 1996, the Centers for Disease Control (CDC) issued guidelines for antepartum antibiotic prophylaxis of group B streptococcal (GBS)-positive women. The objective of this study is to document results of a GBS prophylaxis policy at one nonacademically affiliated, community hospital and discern its effectiveness with regard to compliance as well as in decreasing the incidence of early onset GBS (EOGBS) disease. METHODS: The development of a GBS-prevention policy at the Women's Hospital of Greensboro (WHG) was documented by means of interviews and examination of minutes of meetings. Effectiveness of the policy was assessed by calculating the percentage of all GBS+ or unknown mothers who received antepartum antibiotics during a 1-year period. Additionally, all newborns with any positive GBS culture during the past 13 years at WHG were identified. RESULTS: The policy was formulated and distributed during a 6-month period by strong leadership, community "buy-in," and an educational seminar. A preprinted physician order was written so that all GBS-positive/unknown mothers would receive antepartum antibiotics. Additionally, a clinical pathway was used to track and monitor maternal GBS status. During October 1, 1999 to September 30, 2000, 1124 (23.1%) mothers were found to be GBS positive/unknown. Of those who delivered an infant >37 weeks' gestation and who could be linked to the pharmacy database, 777 (91.1%) received antepartum antibiotics. The incidence of EOGBS disease at WHG before 1996 was 1.93 +/- 0.7/1000 births compared to 0.4 +/- 0.05/1000 after the issuance of the guidelines (p = 0.002, t-test). CONCLUSIONS: Over 90% of GBS-positive mothers were treated with antibiotics at WHG. Associated with this high adherence rate to the CDC guidelines has been a five-fold decrease in the incidence of EOGBS disease. We attribute these results to the implementation of a preprinted physician order sheet to direct intrapartum antibiotics for women with GBS positive or unknown colonization and the use of a clinical pathway to track GBS colonization status.

Antibiotic Prophylaxis↗
PubMed1995

Cost-reducing treatment algorithms for antineoplastic drug-induced nausea and vomiting.

A treatment algorithm and preprinted order form developed to reduce the cost of treating antineoplastic drug-induced nausea and vomiting are described. A team including pharmacists, oncologists, and oncology nurses developed a treatment algorithm to reduce the cost of antiemetic therapy for patients receiving antineoplastic therapy at a 719-bed academic medical center. The algorithm incorporated the following concepts: matching antiemetic therapy with the emetogenic potential of the antineoplastic regimen, reducing ondansetron dosages, increasing the ratio of oral to intravenous therapy, and treating delayed-onset nausea and vomiting without using serotonin-receptor antagonists. To help physicians learn and use the treatment algorithm, it was incorporated into an order form for both antineoplastic and antiemetic drugs. Separate order forms were created for pediatric and adult patients. A comparison of outcome data before and after implementation of the practice guidelines showed that the patient outcomes were at least as good after implementation as before. More than a year after the guidelines were implemented, more than 85% of antiemetic regimens prescribed for antineoplastic drug-induced nausea and vomiting were in compliance with the guidelines. A cost avoidance of nearly $205,000 was realized in the first year. Collaboration with oncologists at the start of the care plan was a key element in its success. An antiemetic treatment algorithm, integrated with a preprinted physician order form, was well accepted and has reduced expenses for antiemetic therapy.

Adult↗