scholarly journals Facility and Regional Factors Associated With the New Adoption of Electronic Medical Records in Japan: Nationwide Longitudinal Observational Study

10.2196/14026 ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. e14026 ◽  
Author(s):  
Hideaki Kawaguchi ◽  
Soichi Koike ◽  
Kazuhiko Ohe
Keyword(s):  
Observational Study ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Factors Associated ◽  
Longitudinal Observational Study ◽  
Regional Factors

scholarly journals Associations between double-checking and medication administration errors: a direct observational study of paediatric inpatients

2020 ◽  
pp. bmjqs-2020-011473
Author(s):  
Johanna I Westbrook ◽  
Ling Li ◽  
Magdalena Z Raban ◽  
Amanda Woods ◽  
Alain K Koyama ◽  
...  
Keyword(s):  
Observational Study ◽  
Medical Records ◽  
Medication Administration ◽  
Clinical Settings ◽  
Paediatric Hospital ◽  
Factors Associated ◽  
Medication Administration Errors ◽  
Multivariable Regression ◽  
Very High ◽  
Considerable Resource

BackgroundDouble-checking the administration of medications has been standard practice in paediatric hospitals around the world for decades. While the practice is widespread, evidence of its effectiveness in reducing errors or harm is scarce.ObjectivesTo measure the association between double-checking, and the occurrence and potential severity of medication administration errors (MAEs); check duration; and factors associated with double-checking adherence.MethodsDirect observational study of 298 nurses, administering 5140 medication doses to 1523 patients, across nine wards, in a paediatric hospital. Independent observers recorded details of administrations and double-checking (independent; primed—one nurse shares information which may influence the checking nurse; incomplete; or none) in real time during weekdays and weekends between 07:00 and 22:00. Observational medication data were compared with patients’ medical records by a reviewer (blinded to checking-status), to identify MAEs. MAEs were rated for potential severity. Observations included administrations where double-checking was mandated, or optional. Multivariable regression examined the association between double-checking, MAEs and potential severity; and factors associated with policy adherence.ResultsFor 3563 administrations double-checking was mandated. Of these, 36 (1·0%) received independent double-checks, 3296 (92·5%) primed and 231 (6·5%) no/incomplete double-checks. For 1577 administrations double-checking was not mandatory, but in 26·3% (n=416) nurses chose to double-check. Where double-checking was mandated there was no significant association between double-checking and MAEs (OR 0·89 (0·65–1·21); p=0·44), or potential MAE severity (OR 0·86 (0·65–1·15); p=0·31). Where double-checking was not mandated, but performed, MAEs were less likely to occur (OR 0·71 (0·54–0·95); p=0·02) and had lower potential severity (OR 0·75 (0·57–0·99); p=0·04). Each double-check took an average of 6·4 min (107 hours/1000 administrations).ConclusionsCompliance with mandated double-checking was very high, but rarely independent. Primed double-checking was highly prevalent but compared with single-checking conferred no benefit in terms of reduced errors or severity. Our findings raise questions about if, when and how double-checking policies deliver safety benefits and warrant the considerable resource investments required in modern clinical settings.

scholarly journals Prevalence, course and factors associated with delirium in elderly patients with advanced cancer: a longitudinal observational study

2015 ◽  
Vol 45 (10) ◽  
pp. 934-940 ◽  
Author(s):  
Megumi Uchida ◽  
Toru Okuyama ◽  
Yoshinori Ito ◽  
Tomohiro Nakaguchi ◽  
Mikinori Miyazaki ◽  
...  
Keyword(s):  
Observational Study ◽  
Elderly Patients ◽  
Advanced Cancer ◽  
Factors Associated ◽  
Longitudinal Observational Study

scholarly journals Prevalence of toddler, child and adolescent overweight and obesity derived from primary care electronic medical records: an observational study

CMAJ Open ◽  
2016 ◽  
Vol 4 (3) ◽  
pp. E538-E544 ◽  
Author(s):  
Suzanne Biro ◽  
Dave Barber ◽  
Tyler Williamson ◽  
Rachael Morkem ◽  
Shahriar Khan ◽  
...  
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Child And Adolescent ◽  
Overweight And Obesity ◽  
Adolescent Overweight

scholarly journals Ocular related emergencies in Spain during the COVID-19 pandemic, a multicenter study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Martín Puzo ◽  
Jorge Sánchez-Monroy ◽  
Carmen A. Porcar-Plana ◽  
Francisco de Asís Bartol-Puyal ◽  
Marina Dotti-Boada ◽  
...  
Keyword(s):  
Observational Study ◽  
Electronic Medical Records ◽  
Multicenter Study ◽  
Medical Records ◽  
Retrospective Observational Study ◽  
Publication Data ◽  
Tertiary Hospitals ◽  
First Cause ◽  
Acute Conjunctivitis ◽  
Punctate Keratitis

Abstract Purpose To evaluate ophthalmological emergencies (OE) during the COVID-19 pandemic comparing them with the same period of the previous year. Methods Retrospective observational study of all OE visits in four tertiary hospitals in Spain comparing data from March 16th to April 30th, 2020 (COVID-19 period) and the same period of 2019 (pre-COVID-19 period). Severity of the conditions was assessed following Channa et al. publication. Data on demographics, diagnosis and treatments were collected from Electronic Medical Records. Results During lockdown, OE significantly declined by 75.18%, from 7,730 registered in the pre-COVID-19 period to 1,928 attended during the COVID-19 period (p < 0.001). In 2019, 23.86% of visits were classified as emergent, 59.50% as non-emergent, and 16.65% could not be determined. In 2020, the percentage of emergent visits increased up to 29.77%, non-emergent visits significantly decreased to 52.92% (p < 0.001), and 17.31% of the visits were classified as “could not determine”. During the pandemic, people aged between 45 and 65 years old represented the largest attending group (37.89%), compared to 2019, where patients over 65 years were the majority (39.80%). In 2019, most frequent diagnosis was unspecified acute conjunctivitis (11.59%), followed by vitreous degeneration (6.47%), and punctate keratitis (5.86%). During the COVID-19 period, vitreous degeneration was the first cause for consultation (9.28%), followed by unspecified acute conjunctivitis (5.63%) and punctate keratitis (5.85%). Conclusions OE visits dropped significantly during the pandemic in Spain (75.18%), although more than half were classified as non-urgent conditions, indicating a lack of understanding of the really emergent ocular pathologies among population.

scholarly journals Ocular related emergencies in Spain during the COVID-19 pandemic, a multicenter study.

2021 ◽  
Author(s):  
Martin Puzo ◽  
Jorge Sanchez-Monroy ◽  
Carmen Alejandra Porcar-Plana ◽  
Francisco de Asís Bartol-Puyal ◽  
Marina Dotti-Boada ◽  
...  
Keyword(s):  
Observational Study ◽  
Electronic Medical Records ◽  
Multicenter Study ◽  
Medical Records ◽  
Retrospective Observational Study ◽  
Publication Data ◽  
Tertiary Hospitals ◽  
First Cause ◽  
Acute Conjunctivitis ◽  
Punctate Keratitis

Abstract PURPOSE: To evaluate ophthalmological emergencies (OE) during the COVID-19 pandemic comparing them with the same period of the previous year. METHODS: Retrospective observational study of all OE visits in four tertiary hospitals in Spain comparing data from March 16th to April 30th, 2020 (COVID-19 period) and the same period of 2019 (pre-COVID-19 period). Severity of the conditions was assessed following Channa et al. publication. Data on demographics, diagnosis and treatments were collected from Electronic Medical Records. RESULTS: During lockdown, OE significantly declined by 75.18%, from 7,730 registered in the pre-COVID-19 period to 1,928 attended during the COVID-19 period (p<0.001). In 2019, 23.86% of visits were classified as emergent, 59.50% as non-emergent, and 16.65% could not be determined. In 2020, the percentage of emergent visits increased up to 29.77%, non-emergent visits significantly decreased to 52.92% (p<0.001), and 17.31% of the visits were classified as “could not determine”. During the pandemic, people aged between 45 and 65 years old represented the largest attending group (37.89%), compared to 2019, where patients over 65 years were the majority (39.80%). In 2019, most frequent diagnosis was unspecified acute conjunctivitis (11.59%), followed by vitreous degeneration (6.47%), and punctate keratitis (5.86%). During the COVID-19 period, vitreous degeneration was the first cause for consultation (9.28%), followed by unspecified acute conjunctivitis (5.63%) and punctate keratitis (5.85%). CONCLUSIONS: OE visits dropped significantly during the pandemic in Spain (75.18%), although more than half were classified as non-urgent conditions, indicating a lack of understanding of the really emergent ocular pathologies among population.

scholarly journals Ward-Level Factors Associated with Methicillin-Resistant Staphylococcus aureus Acquisition − an Electronic Medical Records study in Singapore

2020 ◽  
Author(s):  
Zaw Myo Tun ◽  
Dale A Fisher ◽  
Sharon Salmon ◽  
Clarence C Tam
Keyword(s):  
Staphylococcus Aureus ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Multivariable Analysis ◽  
Acquisition Rate ◽  
Methicillin Resistant ◽  
Patient Transfers ◽  
Factors Associated ◽  
Number Of Patients

Background Methicillin-Resistant Staphylococcus aureus (MRSA) is endemic in hospitals worldwide. When patients are transferred between wards within a hospital, their risk of acquiring MRSA may change. Studies investigating such association are rare. In this study, we assessed how wards are connected and investigated ward characteristics associated with MRSA acquisition. Methods We analysed electronic medical records from an acute-care tertiary hospital in Singapore using data of patient transfers and MRSA screening of hospitalized patients between 2010 and 2013. In multivariable analysis, we used mixed-effects Poisson models with wards and time as random intercept and random slope, respectively. Results Most patient transfers concentrated in a core network of wards that sustained over time. Overall MRSA acquisition rate declined over study period. Factors associated with MRSA acquisition were ward specialty other than surgical, orthopedics, and oncology (rate ratio (RR): 1.69, 95% CI: 1.28, 2.21) (compared to medical ward), MRSA admission prevalence (RR: 1.48, 95% CI: 1.28, 1.71, per one percentage point increase), presence of cohorting beds (RR: 1.81, 95% CI: 1.45, 2.27), critical-care ward (RR: 1.85, 95% CI: 1.21, 2.84) and average number of patients on a typical day (RR: 1.58, 95% CI: 1.24, 2.00, for every 10 patients quarterly). We did not find evidence that ward connectivity influenced MRSA acquisition rate after adjusting for other ward characteristics. Conclusion Our findings highlighted ward characteristics associated with MRSA acquisition. Linked with analytics infrastructure, similar methods could be used to understand the transmission of other nosocomial organisms to inform infection control efforts in real time.

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