Dissertations / Theses on the topic 'Medical guideline'
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Sisterman, Kathryn, and Kathryn Sisterman. "Improving Care for Patients Hospitalized with Heart Failure." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/626616.
Full textHui, Chi-hoi, and 許志海. "Nurse-led non-invasive mechanical ventilation guideline for acute pulmonary oedema patients in acute medical wards." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B4658190X.
Full textEnglish, Thomas MacAndrew. "Impact of an electronic medical record on adherence to current diabetes guidelines in a family medical center." Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2008. https://www.mhsl.uab.edu/dt/2008p/english.pdf.
Full textLeung, Mei-ling, and 梁美玲. "An evidence based guideline of pre- and post operative oronasopharyngeal care for cardiac patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48335642.
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Nursing Studies
Master
Master of Nursing
Onion, Carl William Reginald. "Changes in medical practice following superficial and deep processing of evidence : a controlled experiment in clinical guideline implementation." Thesis, University of Liverpool, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.364176.
Full textChow, Yung-wai, and 周勇偉. "An evidence-based guideline for online health education program for men who have sex with men (MSM)." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48335319.
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Nursing Studies
Master
Master of Nursing
Meyer, David C. "Evaluation of a Tiered Opioid Prescribing Guideline for Inpatient Colorectal Operations." eScholarship@UMMS, 2020. https://escholarship.umassmed.edu/gsbs_diss/1073.
Full textFlippies, Emirenthia Emogin Elouise, and D. J. L. Venter. "The relationship between organisational contextual factors and clinical practice guideline implementation in private critical care units." Thesis, Nelson Mandela Metropolitan University, 2016. http://hdl.handle.net/10948/12583.
Full textCarlisle, Heather Lynn. "Implementing a Clinical Practice Guideline on the Use of Capnography in Monitoring for Opioid-Induced Respiratory Depression on Medical-Surgical Units." Diss., The University of Arizona, 2013. http://hdl.handle.net/10150/293641.
Full textGrauer, Dennis W. "Pharmaceutical guideline compliance and its impact on costs and effectiveness : case studies of orders based on Vancomycin use and intravenous to oral switch antimicrobial guidelines at The Ohio State University Medical Center /." The Ohio State University, 2000. http://rave.ohiolink.edu/etdc/view?acc_num=osu1488203552777345.
Full textRazavi, Amir Reza. "Applications of Knowledge Discovery in Quality Registries - Predicting Recurrence of Breast Cancer and Analyzing Non-compliance with a Clinical Guideline." Doctoral thesis, Linköping : Univ, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-10142.
Full textDahlgren, Hedda. "Adherence to guidelines after sexual assaultat Örebro University Hospital and Karlskoga Hospital." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-61584.
Full textLundberg, Jessica, and Fia Karppinen. "Prehospital undersökning och behandling av patienter med central bröstsmärta." Thesis, Umeå universitet, Institutionen för omvårdnad, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-181622.
Full textPettersson, Billie. "Lipid‐modifying and glucose-lowering therapies in clinical practice : The impact of guidelines and changing reimbursement schemes." Doctoral thesis, Linköpings universitet, Utvärdering och hälsoekonomi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-75545.
Full textOsakwe, Chijioke Pius. "Perceptions of Private Medical Practitioners towards the Nigerian National Tuberculosis Treatment Guidelines." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4939.
Full textBradbrook, Kirsty. "Deliberative artificial intelligence in the development, refinement and use of medical guidelines." Thesis, University of Brighton, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.438522.
Full textHagman, Anna, and Sander Riedberg. "Guidelines for smartphone usage in telemedical photography." Thesis, KTH, Skolan för teknik och hälsa (STH), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-150492.
Full textAziz, Ayesha. "A service oriented architecture to implement clinical guidelines for evidence-based medical practice." Thesis, University of Sussex, 2015. http://sro.sussex.ac.uk/id/eprint/53223/.
Full textJansen, Friso Johannes. "The shifting sands of evidence : a socio-legal enquiry into the development of medical guidelines." Thesis, University of Oxford, 2017. https://ora.ox.ac.uk/objects/uuid:efd9b784-3df7-400e-bb0a-8f898578bc91.
Full textBenjamin, Jennifer Claudette. "Incorporating ADA Best Practice Guidelines in Electronic Medical Records to Improve Glycemic Management in Hospitals." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/318.
Full textStien, Beate. "Det är patienten som behandlas inte symtomet : Distriktssköterskans erfarenheter av det preventiva arbetet med patienter som har hypertoni." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-16767.
Full textProgram: Specialistsjuksköterskeutbildning med inriktning mot distriktssköterska
Hansson, Amina. "PROLACTINOMA : Treatment and outcome of patients in a Swedish county." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-93342.
Full textMurphy, Rebecca Cowell. "Advocating for advance directives guidelines for health care professionals /." Thesis, Montana State University, 2009. http://etd.lib.montana.edu/etd/2009/murphy/MurphyR0509.pdf.
Full textMxoli, Ncedisa Avuya Mercia. "Guidelines for secure cloud-based personal health records." Thesis, Nelson Mandela Metropolitan University, 2017. http://hdl.handle.net/10948/14134.
Full textSOUZA, RAPHAELA GASPARINI FRANCOIS DIEHL DE. "METHOD PROPOSAL TO TRANSFORM MEDICAL GUIDELINES TO A CONCEPTUAL PROCESS MODEL: A CASE STUDY FOR SEPSIS." PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2016. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=29839@1.
Full textCOORDENAÇÃO DE APERFEIÇOAMENTO DO PESSOAL DE ENSINO SUPERIOR
CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO
PROGRAMA DE SUPORTE À PÓS-GRADUAÇÃO DE INSTS. DE ENSINO
Uma das principais questões dos profissionais de saúde é como aprimorar a qualidade do tratamento oferecido aos pacientes. Problemas relacionados à qualidade e altos custos nos serviços de saúde são observados não somente no Brasil, mas também em países desenvolvidos. A grande variação no processo de tratamento de uma determinada doença pode gerar erros médicos, uso excessivo de recursos e sofrimento desnecessário aos pacientes. Por esse motivo, atualmente muitas instituições ao redor do mundo desenvolvem diretrizes clínicas baseadas em evidências, com recomendações para o tratamento de diversas doenças. A utilização de diretrizes clínicas pode reduzir a variabilidade no processo de tratamento e trazer benefícios como redução da mortalidade e redução de custos. No entanto, existe uma grande dificuldade para implementação destas diretrizes. Normalmente escritas por médicos, estes documentos são de difícil leitura para não-médicos, que tem um papel importante em sua implementação, como desenvolvedores de sistema e administradores. Esta dissertação propõe um método para transformar diretrizes clínicas em um modelo de processo conceitual que possa ser implementado num software. O método proposto facilita a leitura e entendimento das recomendações presentes nestas diretrizes. A transformação das recomendações em informações de processo facilita a implantação das diretrizes em qualquer departamento hospitalar. Além disto, o método permite a comparação de recomendações propostas em diferentes publicações de diretrizes clínicas. O método proposto foi aplicado no processo de diagnóstico e tratamento da Sepse. A Sepse é uma condição grave que acomete milhões de pessoas por ano no mundo, com altos índices de mortalidade. A rapidez na identificação dos sintomas e início do tratamento adequado aumenta significativamente a probabilidade de sobrevivência. A intenção do método proposto nesta dissertação é aumentar a utilização de diretrizes clinicas de Sepse em hospitais. O modelo de processo conceitual apresentado no método será utilizado no desenvolvimento de uma solução tecnológica real para suportar o processo de identificação e tratamento da Sepse em hospitais. Este modelo foi construído com base na revisão da literatura de Sepse e no estudo de caso realizado em um hospital de grande porte no Brasil. O modelo desenvolvido foi validado por médicos durante o estudo de caso e por uma equipe de especialistas em desenvolvimento de sistemas hospitalares.
One of the main issues for health professionals is how to improve the quality of care offered to patients. Problems related to healthcare quality and high costs are observed not only in Brazil but also in developed countries. The wide variation in a particular disease treatment process can lead to medical errors, overuse of resources and unnecessary patient suffering. Therefore, nowadays many institutions around the world are developing clinical evidence-based guidelines with recommendations for the treatment of several diseases. However, there is a great difficulty to implement these guidelines. Usually written by doctors, these documents are difficult to read by non-physicians, who play an important role in its implementation, such as system developers and administrators. This master thesis proposes a method to transform clinical guidelines in a conceptual process model that can be implemented in a software. The method facilitates the reading and understanding of these guidelines recommendations. The transformation of guidelines recommendations in process information facilitates its implementation in any hospital department. The proposed method was applied for the Sepsis diagnosis and treatment process. The conceptual process model designed in this Master Thesis will be used in the development of a Clinical Pathway technological solution for Sepsis treatment. Sepsis is a serious medical condition that affects millions of people worldwide each year, with high mortality rates. The early recognition of its symptoms and proper treatment significantly increases the survival probability. The intent behind the proposed method in this thesis is to increase the use of clinical guidelines for Sepsis in hospitals.
Godlonton, Michael D. "Evaluating prevention strategies used by general practitioners in Grahamstown in terms of recommended guidelines." Thesis, Stellenbosch : University of Stellenbosch, 2015. http://hdl.handle.net/10019.1/97241.
Full textYeung, Mei-yan, and 楊美恩. "Evidence-based guidelines on ventilator-associated pneumonia prevention for mechanically ventilated patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B44626885.
Full textKativu, Kevin. "Guidelines for the effective use of telemedicine in public healthcare in resource constrained settings." Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1020061.
Full textMasieri, C. M. "L'ACCERTAMENTO DELLA RESPONSABILITÀ CIVILE DEL MEDICO TRAMITE L'UTILIZZO DELLE LINEE-GUIDA E DEGLI ALTRI DOCUMENTI SCIENTIFICI." Doctoral thesis, Università degli Studi di Milano, 2017. http://hdl.handle.net/2434/490018.
Full textPHD DISSERTATION - ABSTRACT - THE ASCERTAINMENT OF MEDICAL MALPRACTICE THROUGH CLINICAL PRACTICE GUIDELINES AND OTHER SCIENTIFIC DOCUMENTS. This PhD dissertation aims to analyze a specific aspect of Medical Malpractice Law: the use of scientific documents – known as practice parameters, practice patterns, written policies, protocols, standards or clinical practice guidelines – by rule makers (legislators and Courts) in order to identify the standard of care for health care practitioners. In the first chapter, after a short introduction on fundamental notions of medical epistemology, guidelines’ content and their production, some interactions between Science and Law are described, picking the European Union Law, Council of Europe Law and finally Italian Law. Research on guidelines and Medical Malpractice calls for taking the advantage of Comparative Legal Studies. In particular, the legal system of the United States of America has been chosen. This because American scholars have first proposed in the ‘80s to use guidelines in Medical Malpractice trials. The second chapter offers thus a detailed picture of the sources of the law, including the role of state and federal Courts in making American Law. Focusing then on Medical Malpractice, it has to be said that the majority of the States adopted medical custom as the standard of care, which is a matter of fact, to be proven in front of the jury. According to this, in Medical Malpractice trials expert witness testimony about medical custom became very relevant, but no Court in the U.S. appoints experts. This, and the fact that the plaintiff retains the burden of proof of the breach of duty, makes partisan expert testimony mandatory for the claim of the patient to be heard by the jury. Therefore, Courts and scholars in the United States put guidelines in the Evidence Law frame, looking at how they interact – or sometimes clash – with expert testimonies. So, the chapter ends with an analysis of the Law of Evidence, with a focus on the so called “Daubert test” on expert witnesses, and one on the admissibility of documents. The third chapter demonstrates that the use of clinical practice guidelines in Medical Malpractice trials is way more frequent than American scholars think. Furthermore, it shows that the above-mentioned rules of Evidence are still the most relevant source of the law governing admissibility and relevance of these documents. Evidence Law indeed is far more relevant than the small number of state and federal statutes on Medical Malpractice that mention guidelines as a judicial tool for assessing liability. But these statutes seem to have inspired the Italian legislator seems adopting the so called “decreto Balduzzi” (see art. 3, comma 1 d.l. n. 158 of 2012 – l. n. 189 of 2012). The fourth chapter goes back to the Italian legal system, describing the path that brought Medical Malpractice from Tort Law to Contract Law through the so called “contatto sociale” doctrine. Furthermore, the case law caused some distortions of the rules that are now similar to strict liability. The fifth chapter describes a legal transplant from American Tort Law to the very different Italian legal environment: the idea of giving a defense to doctors who complied with clinical practice guidelines. Anyhow, some American state statutes, not the prevailing traditional Evidence Law pattern, have influenced the Italian legislator. Moreover, the conceptual framing of clinical practice guidelines under Italian Law is very different from the original. In Italy, Medical Malpractice is a branch of Contract Law, according to which the clinician is bound to perform treatments with the due technical expertise (“perizia”). Scientific documents can help Courts to define doctor’s behavior as coping with technical expertise, which is a matter of law. Guidelines cannot prove any fact. Therefore, they are not related to Evidence Law. The core of this PhD dissertation is that Italian Courts have to take judicial notice of clinical practice guidelines in Medical Malpractice trials. This comes out of the “iura novit curia” principle (“The Court must know the law” principle) and art. 3, co. 1 of decreto Balduzzi, which explicitly talks about clinical practice guidelines and iatrogenic injuries. The above-mentioned scientific documents have also to pass muster under a test of applicability to the case and scientific validity. This dissertation suggests taking the advantage of the American experience, in particular of the so called “Daubert doctrine”. However, even this would be a legal transplant, in which the original model would be surely modified, as this work shows. Finally, the fifth chapter describes how Cassazione Court could reverse lower Courts’ decisions that apply clinical practice guidelines in Medical Malpractice cases.
Önder, Stefan. "Adrenal incidentaloma : – A retrospective study of cardiovascular mortality and morbidity in patients with hypercortisolemia defined by the European Society of Endocrinology guidelines." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-77252.
Full textBallou-Nelson, Pamela. "A Synthesized Model of Compliance Based on Physician and Patient Reported Barriers to Hypertension Guidelines." ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/977.
Full textLasker, Judith N., Myron Aldrink, Ramaswami Balasubramaniam, Paul Caldron, Bruce Compton, Jessica Evert, Lawrence C. Loh, Shailendra Prasad, and Shira Siegel. "Guidelines for responsible short-term global health activities: developing common principles." BIOMED CENTRAL LTD, 2018. http://hdl.handle.net/10150/627194.
Full textMassuthe, Peter. "Operating guidelines for services /." [Amsterdam] : SIKS, 2009. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=017682193&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
Full textLundberg, Camilla, and Karin Winge. "Prehospital bedömning : En forskningsöversikt." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-18828.
Full textProgram: Fristående kurs
Uppsatsnivå: C
Van, Niekerk Anida. "Implementation of intravenous to oral antibiotic switch therapy guidelines in the general medical wards of a tertiary level hospital." Thesis, Nelson Mandela Metropolitan University, 2010. http://hdl.handle.net/10948/1325.
Full textKabbur, Nikhil. "Design and Manufacturing Guidelines for Additive Manufacturing of High Porosity Cellular Structures." University of Cincinnati / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1504878916930908.
Full textRegulapati, Sushmitha. "Natural language processing framework to assist in the evaluation of adherence to clinical guidelines." Morgantown, W. Va. : [West Virginia University Libraries], 2007. https://eidr.wvu.edu/etd/documentdata.eTD?documentid=5340.
Full textTitle from document title page. Document formatted into pages; contains vii, 36 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 33-36).
Molander, Tobias, and Kin Tran. "Kvalitetsgranskning av svenska ambulanssjukvårdens behandlingsriktlinjer rörande patienter med svår sepsis och septisk chock." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-16687.
Full textProgram: Specialistsjuksköterskeutbildning med inriktning mot ambulanssjukvård
Mpasa, Ferestas. "Strategies for the implementation of clinical practice guidelines in the intensive care : a systematic review." Thesis, Nelson Mandela Metropolitan University, 2014. http://hdl.handle.net/10948/d1020046.
Full textBuhajeeh, Eman A. A. "Diabetes in Kuwait - current patients' experiences of their medical treatment(s) with emphasis on renal complications as compared with worldwide guidelines." Thesis, University of Bradford, 2015. http://hdl.handle.net/10454/14182.
Full textCourt, Alex J. "They're NICE and neat, but are they useful? : a grounded theory of clinical psychologists' beliefs about, and use of, NICE guidelines." Thesis, Canterbury Christ Church University, 2014. http://create.canterbury.ac.uk/12832/.
Full textCandido, Patricia Tavares da Silva. "O internato médico após as Diretrizes Curriculares Nacionais de 2014: um estudo em escolas médicas do estado do Rio de Janeiro." Universidade Federal de São Paulo, 2017. http://repositorio.unifesp.br/11600/45815.
Full textIntrodução: Instituídas em 2014, as Diretrizes Curriculares Nacionais (DCNs) do Curso de Graduação em Medicina contêm várias recomendações, especialmente para o Internato Médico. Apesar do reconhecimento da necessidade de mudanças na educação médica, no que se refere à capacitação profissional para atender as demandas da comunidade, a instituição dessas DCNs foi considerada, por muitos, pouco democrática. O seu processo de implantação pelas Escolas Médicas ainda é pouco estudado. Objetivos: Analisar o Internato Médico em Escolas Médicas do Estado do Rio de Janeiro, após a instituição das Diretrizes Curriculares Nacionais para o Curso de Graduação em Medicina de 2014, sob a ótica dos Coordenadores/Diretores de Curso e Coordenadores do Internato. Metodologia: Nessa investigação, foram utilizadas abordagens qualitativas e quantitativas, com a participação dos Coordenadores/Diretores de Curso e Coordenadores de Internato. Em março de 2016, o Estado do Rio de Janeiro possuía 19 cursos de medicina em 15 Escolas Médicas. Destes, nove cursos participaram da pesquisa. A população de estudo foi representada por 13 participantes, nove Coordenadores de Curso e quatro Coordenadores de Internato. Foi aplicado um instrumento de pesquisa composto por questões fechadas, abertas e uma escala atitudinal. Para a análise dos dados, a escala foi avaliada por análise estatística e as respostas das questões abertas foram submetidas à análise de conteúdo, na modalidade análise temática. Resultados e Discussão: Na visão dos Coordenadores participantes da pesquisa, todas as Escolas Médicas estão em processo de adequação às determinações das DCNs de 2014. A maioria está de acordo com a inclusão obrigatória, no Internato, das áreas de Urgência e Emergência, Atenção Básica e Saúde Mental. Muitas são as dificuldades encontradas no processo de implantação e/ou reestruturação dessas atividades no Internato: a escassez de cenários; precariedade dos cenários existentes na Emergência do Sistema Único de Saúde; falta de docentes/preceptores e o prazo estabelecido para a implantação das Diretrizes. Entretanto, os coordenadores têm planejado/utilizado algumas estratégias como a diversificação dos cenários de prática, a criação de estágios eletivos, o estabelecimento de convênios e parcerias, o desenvolvimento de atividades integradas com outras áreas do Internato e a utilização de laboratórios de simulação realística. Considerações finais: As Escolas Médicas vivem um momento de transformação curricular, impulsionado pelas DCNs. Esse momento deve ser encarado como uma oportunidade para revisitar o Internato Médico e, possivelmente, encontrar estratégias para o aprimoramento da formação médica nesse espaço privilegiado da graduação. Acredita-se que a divulgação dos resultados dessa pesquisa possa auxiliar as Escolas Médicas no processo de apropriação e implantação das determinações das DCNs de 2014.
Introduction: Instituted in 2014, the National Curricular Guidelines (NCG) of the Undergraduate Medical Course contains several recommendations, especially for the Medical Internship. Despite the recognition of the need for changes in medical education, in terms of professional training to meet the demands of the community, instituting these NCG was considered by many to be less democratic and its implementation process by the Medical Schools is still little studied. Objectives: to analyze the Medical Internship in Medical Schools of the State of Rio de Janeiro, after instituting the National Curricular Guidelines for the Medical’s Undergraduate Course of 2014, according to the Coordinators / Course Directors and Internship Coordinators. Methodology: In this research, qualitative and quantitative approaches were used, with the participation of Coordinators / Course Directors and Internship Coordinators. In March 2016, the State of Rio de Janeiro had 19 medical courses in 15 Medical Schools. Of these, nine courses participated in the research. The study population was represented by 13 participants and of these 09 Course Coordinators and 04 Internship Coordinators. We applied a research instrument composed of closed-ended and open-ended questions and an attitudinal scale. For data analysis, the scale was evaluated by statistical analysis and the answers of the open-ended questions were submitted to content analysis, in the thematic analysis modality. Results and discussion: In the view of the Coordinators participating in the research, all Medical Schools are in the process of adapting to the NGC’s determinations of 2014. The majority are in agreement with the mandatory inclusion of Urgency and Emergency, Primary Care and Mental Health in the Internship areas. There are many difficulties that we encountered in the process of implantation and / or restructuring of these activities in Internship: the scarcity of scenarios; precariousness of the existing scenarios in the Emergency of the Unified Health System; lack of teachers / preceptors; and the deadline established for the implementation of the Guidelines. However, the coordinators have planned / used some strategies such as the diversification of practice scenarios, the creation of elective internships, the establishment of agreements and partnerships, development of integrated activities with other Internships areas and the use of realistic simulation laboratories. Final considerations: The Medical Schools live a moment of curricular transformation, encouraged by the NCG. We must see this moment as an opportunity to revisit the Medical Internship and, possibly, to find strategies for the improvement of medical training in this privileged space of the undergraduate. We believe that the dissemination of this research’s results can help the Medical Schools in the process of appropriation and implementation of NCG’s determinations of 2014.
Roman, Angelmar Constantino. "Informatização do registro clínico essencial para a atenção primária à saúde: um instrumento de apoio às equipes da estratégia saúde da família." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5144/tde-28082009-095729/.
Full textINTRODUCTION: Primary healthcare is the major portal of entry into organized health systems. In this setting attention to given not only to analysis of health risks characterized by classified diseases but also to social and emotional factors. The Brazilian public healthcare system (Sistema Único de Saúde - SUS) has utilized this integrated model since its inception in 1990. Family and community medicine is the specialty of Primary Care and is compatible with these principles. However, clinical education, often based on a dominance of clinical secondary and tertiary care with a strong bias towards experimental biomedicine has a strong influence over the manner in which clinical events are registered and coded. These factors can create limitations to data registry and is often inadequate to encompass the complex environment which is encountered in the day to day experience of the majority of patients encountered in Primary Care. The present work is based on the integration of the method of Weed of problem oriented medical record taking with an automation of clinical records and cardiovascular risk factor monitoring and management. We describe the results of the use of a software program for improving the essential clinical patient record during patient visits , including guided cardiovascular risk management surveillance. The software program is compatible with the principles of SUS, the Primary Care setting and the philosophy of Family Medicine. METHODS: In 2003, in an Primary Health Care ambulatory setting outpatients, 20 years or older, were either treated by care using the automated patient record including the riskfactor surveillance software (Intervention group, n= 616) or were treated following the standard practice protocols of their family physicians (Control Group, n=3577). At the end of the year patient outcomes and overall patient care costs were compared between the two groups. RESULTS: The average of the number of events (auxiliary tests, specialized referrals, and hospital admissions) decreased from 29.28 events per patient/year in the control group to 22.00 events per patient/year (p < 0,001) in the intervention group. Similarly the cost per patient/year decreased from R$1,130.34 to R$611.51 (p < 0.001), and the average cost per procedure decreased from R$25.96 to R$19.85 (p < 0.001) for the control and intervention groups, respectively. CONCLUSIONS: Our results demonstrated that the use of an primary care automated clinical patient record, including a software program to automate cardiovascular risk factors guidelines, can decrease the number and cost of complementary exams, referrals to specialists, and hospital procedures arising from primary care consultations.
Neeser, Rudolph. "A Comparison of Statistical and Geometric Reconstruction Techniques: Guidelines for Correcting Fossil Hominin Crania." Thesis, University of Cape Town, 2007. http://pubs.cs.uct.ac.za/archive/00000413/.
Full textFinley, Leslie K., Alice M. Crawford, and Benjamin J. Roberts. "Career planning in the Medical Service Corps: assessing the validity of current guidelines through a comparative analysis of duty tours and training schools." Thesis, Monterey, California: Naval Postgraduate School, 1993. http://hdl.handle.net/10945/24125.
Full textHernandez, John B. "Evaluating a multi-hospital quality improvement strategy to implement clinical guidelines for radiographic contrast agents." Santa Monica, CA : Rand, 1998. http://catalog.hathitrust.org/api/volumes/oclc/42204634.html.
Full textJohansson, Axel. "Patient Empowerment and Accessibilityin e-Health Services : Accessibility Evaluation of a Mobile WebSite for Medical Records Online." Thesis, Uppsala universitet, Avdelningen för visuell information och interaktion, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-262241.
Full textGordon, Leigh. "Medical consequences in endurance sports - Two Oceans Marathon longitudinal study : an evaluation of participation guidelines in runners presenting with symptoms of acute illness before competition." Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/13109.
Full textBackground: One of the most common clinical decisions a Sports and Exercise Medicine (SEM) physician is required to make is whether an athlete presenting with symptoms or signs of an acute illness can participate in exercise training or competition. Currently, a clinical tool, known as the ‘neck check’ is used to determine eligibility to participate in exercise training or competition athletes with acute illness. This original clinical tool, first described about 20 years ago, was based mainly on an abbreviated medical history and findings of a clinical examination were excluded. Symptoms of illness ‘above-the-neck’ e.g.sneezing, rhinorrhoea or sinus congestion constitute a ‘passed’ “neck check”, whereas ‘below-the-neck’ symptoms e.g.cough and/or systemic symptoms such as fever and myalgia, constitute a ‘failed’ “neck check”. However, in the current literature, there remain very few data regarding 1) the adherence of athletes to advice given following a ‘neck check’, and 2) whether the exercise performance (e.g.the ability to finish a race) or the development of medical complications during exercise is different in athletes who “passed” or “failed” the ‘neck check’. Objective The main objectives of this dissertation are: 1) to review the available evidence with respect to medical assessment and participation risk in endurance runners presenting with symptoms of acute illness before a road race; 2) to document the range of acute illnesses in runners presenting in the 3 days before a race; 3) to determine adherence to advice given by medical staff to these runners, and 4) to determine the effects of the outcomes of the medical assessment on running performance particularly, the ability to finish the race and the medical complications experienced during the race. These data are important to improve the medical care of runners (and other athletes) presenting with acute illness before training and competition. Methods: Phase 1: Review of the literature All literature relating to the epidemiology of acute illness in athletes, risk factors for illness, and participation risk, potential medical complications and effects on performance of exercising whilst ill were sourced using established electronic databases (PubMed, Medline, Google Scholar). In addition, literature related to the background of the ‘neck check’, as well as the evolution of the current RTP guidelines in athletes with acute illness were sourced. Phase 2: Research study In a prospective cohort study, 242 runners who presented to a pre-race registration medical facility with medical concerns were assessed by SEM physicians by means of medical history and physical examination (if indicated) using a specific Pre-Race acute Illness Medical Assessment (PRIMA group). 172 of these runners had evidence suggesting acute infective illness (PRIMA-I group) and 70 runners had non-infective complaints (PRIMA-N/I group). The epidemiology (prevalence rate = % runners) of runners with symptoms, signs and specific clinical diagnoses of acute illnesses were documented in the PRIMA-I group. Following clinical evaluation, all the runners in the PRIMA-I group were then advised regarding clearance to run the race, monitoring symptoms, or not running the race, using the ‘neck check’ as a guideline. Runners in the PRIMA cohort were then tracked during and immediately after the race, and the following parameters were compared to those in a control group of runners not presenting to the medical facility at registration (CON=53 734): 1) incidence of not starting of the race (per 1000 runners) (DNS rate), 2) incidence of not finishing the race in those who started (per 1000 runners) (DNF rate), and 3) incidence of medical complications during the race in those who started (per 1000 runners) (MC rate). Results Phase 1: Review The main finding of the review is the relative paucity in clinical data with respect to participation in athletes with acute illness. Upper respiratory tract symptoms are very common in athletes, and the risk factors are discussed. Furthermore, there are different aetiologies underlying athletes’ URT symptoms (other than infection). The documented risks of exercising when systemically ill include sudden cardiac death and reduced pulmonary function, splenic rupture in patients with infectious mononucleosis, and dehydration and electrolyte disturbances when exercising with acute gastro-intestinal illness. There is little evidence in the literature regarding the effects of illness on performance; these include reduced performance, non-participation and the potential effects of WARI (wheezing after respiratory tract infection). Evidence supporting the two aspects of the neck check is reviewed: the presumed safety of exercising with localised URT symptoms, and the perceived risk of exercising with lower respiratory tract or systemic symptoms. Clinical data are severely lacking, and the available data are based on self-reported symptomatology. There are no published data regarding the use of the ‘neck check’ as a participation guideline. Phase 2: In the PRIMA-I cohort of 172 runners, the most common symptoms were sinus congestion (40.1%), cough (38.2%), sore throat (37.8%) and runny nose (25.6%). More than half the cohort (57.5%) had a diagnosis of localised URTI. However, URTI with generalised symptoms was the single most common diagnosis (22.7%). In the PRIMA-I group, 41.3% of the runners failed the ‘neck check’. Compared with the CON group, there was no significant difference in the DNS rate in the PRIMA-I group. However, in those runners who were advised not to run, the DNS rate was 565 per 1000 runners, and this was significantly higher than that of the CON group (192 per 1000 runners) (p<0.0001). PRIMA-I race starters had a higher DNF rate (31 per 1000 runners), and runners with any medical concerns (PRIMA group) had a significantly higher DNF rate (37 per 1000 runners) compared to the CON group of runners who started the race (15 per 1000 runners) (p= 0.0329). There were no documented medical complications in the PRIMA-I group who started the race, while the MC rate of the CON group was 6.7 per 1000 runners. In runners in the PRIMA-I group who had been advised not to run, 43.5% were non-adherent, and started the race despite this advice. Conclusion: Our study indicates that localised upper respiratory tract infection is responsible for the majority of acute illness in a pre-race cohort of runners. Furthermore, the data provide some evidence that it is safe for runners with acute illness to exercise if they pass the ‘neck check’. However, presenting to a pre-race registration medical facility, failing the ‘neck check’ and receiving advice against participation appear to increase the risk of not finishing a race. There is also concern about the high rate of non-adherence to advice given by the SEM physician. Finally, a pre-race registration medical assessment for runners with acute illness may reduce the risk of developing short-term medical complications during the race.
Karlsson, Sara, and Lina Kristensson. "Attityder och följsamhet vid handhygien hos sjukvårdspersonal." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25500.
Full textThe aim of this study was to compile scientific knowledge of health personnel’s attitudes towards hand hygiene. The result is based on 10 scientific articles. The result shows that health personnel have a positive attitude toward hand hygiene when contact with patients or exposure of body fluids. On the other hand, negative attitude are shown when using gloves, believes that hand hygiene causes skin irritation or when hand disinfection is not easily accessible. Personnel’s knowledge and their superior’s opinions about hand hygiene have an effect on the personnel’s attitude. The summary is that more knowledge among the personnel is needed to change their attitudes and behaviour of hand hygiene. More research about health personnel’s attitudes towards hand hygiene are even needed in a more specific way where different professions attitudes are investigated, so that education can adjust to their particular needs.
Hermansson, Anna, and Strandell Charlotta Jonsson. "Faktorer som påverkar hälso- och sjukvårdspersonals följsamhet till riktlinjer vid MRSA på sjukhus : En litteraturöversikt." Thesis, Högskolan i Skövde, Institutionen för hälsa och lärande, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-13563.
Full textBackground: Transmission of Meticillinresistenta Staphylococcus Aureus has increased in recent years, which places greater demands on health professionals’ adherence to guidelines for infection control. Several studies shows that adherence to guidelines is low which is causing the patient suffering and higher costs for healthcare service. Aim: To illuminate factors that influence health professionals’ adherence to guidelines on MRSA in hospital care. Method: This literature review is based on qualitative (n=3) quantitative (n=7) and mixed method (n=3) scientific articles. Findings: Four categories emerged; knowledge, work environment, organization and negative approach, with nine subcategories. Conclusion: To increase adherence to guidelines regarding MRSA, education, communication and information is required continuously. Increased knowledge would improve health professionals’ approach to patients, relatives and employees, which in turns create confidence in their profession. This might also create opportunities to reduce the staffs concerns of being infected or spreading the infection to family members. Healthcare service is facing a great challenge where understaffing, overcrowding and placement of equipment deficiencies. The organization has a significant responsibility to create structure and conditions for an active and committed leadership to improve factors that may affect the spread of MRSA.