Journal of evaluation in clinical practice
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Falls and fall-related injuries are major problems in hospitals. The aim of this study was to examine the impact of fall prevention guidelines on falls and fall-related injuries in hospitals. ⋯ The present results of the multilevel analysis show that falls and fall-related injuries can be reduced by the implementation of fall prevention guidelines.
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The Health and Social Care Act 2008 sets out the requirement for the introduction of responsible officers for the NHS. The paper states that these individuals will be responsible for ensuring that doctors who are revalidated meet the required standards. It is not known how well prepared prospective responsible officers are for their new role. ⋯ We found important issues regarding the arrangements for revalidation which have not previously been described which may impact on the effectiveness of prospective responsible officers.
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As the discipline of health services research has developed so methods of evaluation have become increasingly sophisticated; where once a 'simple' randomized controlled trial would have been considered the gold standard, now terms such as 'complex interventions' and the 'cluster randomized controlled trial' are hot topics for discussion. The challenges involved in carrying out such studies are rarely presented. In this paper we discuss some of these challenges in relation to ethical and statistical considerations, and illustrate them using a recently completed cluster randomized controlled trial of a decision tool for early labour.
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Patient deprivation is associated with greater need for total hip and knee replacement surgery (THR/TKR) and a higher prevalence of risk factors for surgical complications. Our aim was to examine associations between deprivation and aspects of the inpatient episode for patients undergoing these procedures. ⋯ Our findings suggest differential selection of healthier patients for surgery. Hospitals serving deprived communities may have excess, unfunded costs because of the increased length of stay of socioeconomically disadvantaged patients.
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To arrive at an agreed, prioritized ranking of treatment uncertainties in asthma that need further research, by developing a collaboration of patients, carers and clinicians, facilitated by the James Lind Alliance Working Partnership between Asthma UK and the British Thoracic Society. ⋯ The key outcome is the generation of a prioritized list of treatment uncertainties in asthma, agreed by a collaboration of patients and health professionals, to inform the commissioning of new research. Such a large number of patient-identified treatment uncertainties had not previously been identified in the literature, an indication perhaps that asthma self-management is a neglected research area. Whether the results have an influence of research funding decisions is not yet known.