Journal of evaluation in clinical practice
-
The aim of this study was to explore factors that influence individuals' attitudes towards mandatory vaccination in Greece. ⋯ This survey revealed that most Greek citizens support mandatory vaccination, which was critically affected by the utilization of preventive services and trust in healthcare authorities. Our results suggest that healthcare policy interventions should promote mandatory vaccination through multi-level initiatives to improve healthcare providers' and the general public's understanding of the value of vaccination.
-
Prescribed opioids are major contributors to the international public health opioid crisis. Such widespread iatrogenic harms usually result from collective decision failures of healthcare organizations rather than solely of individual organizations or professionals. Findings from a system-wide safety analysis of the iatrogenic opioid crisis that includes roles of pertinent healthcare organizations may help avoid or mitigate similar future iatrogenic consequences. In this retrospective exploratory study, we report such an analysis. ⋯ The iatrogenic crisis has multiple intricately linked roots. The major catalyst: pervasive pharma-linked financial conflicts of interest (CoIs) involving most other healthcare organizations. These extensive financial CoIs were likely triggers for a cascade of erroneous decisions and actions that adversely affected patients. The actions and decisions of pharma ranged from unethical to illegal. The iatrogenic opioid crisis may exemplify 'institutional corruption of pharmaceuticals'.
-
One knowledge translation method, of putting evidence into practice, is the use of clinical practice guidelines (CPG). The purpose of this brief report is to describe an 8-step process of "how to" contextualize a training programme to increase CPG-uptake for a targeted audience in a clearly defined setting. This process may assist implementation practitioners to fast-track the development of contextualized training to improve CPG-uptake.
-
Sturmberg and Martin in 2020 argue that universal health coverage (UHC) is mainly about financing, and primary health care (PHC) is about the right care at the right time to ensure health. They maintain that the World Health Organization has recently sent the wrong message about the "pillars" of PHC in their relationship to UHC. An understanding of political economy is required in order to come to terms with the bases of PHC and the fundamentals of UHC that dealing with inequities is not only an economic issue but fundamentally a political issue. ⋯ PHC is a changing system based on power relationships involving funders and the health community. In Australia as in several countries, out-of-pocket costs have grown rapidly and have affected access for some groups to PHC and have challenged the pretext of equity in UHC. In the context of PHC and UHC, we support the position that health for all goes beyond health care for all, to embrace healthy lives promoting wellbeing.
-
Pressure ulcers may have severe impacts on the quality of life of patients, including pain, low mood and restrictions in performing daily life and social life activities. In Switzerland, 4% of patients develop hospital-acquired pressure ulcers. Six hospitals teamed up with the Vaud Hospital Federation (Switzerland) in a Breakthrough Collaborative, with the goal of reducing hospital-acquired pressure ulcers by 50%. The aim of this study was to assess the actual reduction. ⋯ The Breakthrough Collaborative using a multimodal improvement approach combined with measurement and feedback was associated with a statistically and clinically significant improvement in compliance to best practice and with a reduction of hospital-acquired pressure ulcers by half.