Journal of evaluation in clinical practice
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Decision-making in musculoskeletal health care is complex, with discrepancy among clinical providers and variation in the per cent of referrals for specialist care. To date, there is an increased focus on specialist referrals, risking overuse of expensive testing and contributing to unnecessary treatment. ⋯ Therefore, this preliminary report offers a start towards clarifying key factors and an approach for implementing improved shoulder clinical care decision-making which could then be adapted and applied to other body sites.
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Little is known about hesitancy to receive the COVID-19 vaccines. The objectives of this study were (1) to assess the perceptions of healthcare workers (HCWs) and the general population regarding the COVID-19 vaccines, (2) to evaluate factors influencing the acceptance of vaccination using the health belief model (HBM), and (3) to qualitatively explore the suggested intervention strategies to promote the vaccination. ⋯ Awareness campaign can focus on enhancing the vaccine perceived benefit, debunking misconceptions, and increasing the disease perceived severity. Additionally, the public health leaders need to minimize the perceived barriers by providing the vaccines and appeasing people concerns about their storage, effectiveness, and adverse events.
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Inappropriate use of telemetry frequently occurs in the inpatient, non-intensive care unit setting. Telemetry practice standards have attempted to guide appropriate use and limit the overuse of this important resource with limited success. Clinical-effectiveness studies have thus far not included care settings in which resident-physicians are the primary caregivers. ⋯ These findings expand our understanding of telemetry use in the academic care setting in which trainees serve as the primary caregivers. Furthermore, these findings represent an important addition to the telemetry and patient monitoring literature by demonstrating the impact that nurse-managed protocols can have on telemetry use and by highlighting effective strategies to improve telemetry use by physicians in training.
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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.
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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.