Journal of evaluation in clinical practice
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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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There are various models attempting to predict 30-day readmissions of acutely admitted internal medicine patients. However, it is uncertain how to create a parsimonious index that has equivalent predictive ability and can be extrapolated to other settings. ⋯ An index derived from the number of previous hospital admissions, days since last admission, age, and length of stay in days differentiated between the risks of readmission within 30 days without the need for discharge diagnosis and laboratory variables.
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Medication discrepancies place patients discharged from hospital at risk of adverse medication events. Patient and family participation in medication communication may improve medication safety. This study aimed to examine older medical patient and family participation in discharge medication communication. ⋯ More active patient and family participation could be achieved by encouraging them to identify medication-related problems. To create a climate for patient and family participation, health care professionals should use written communication tools, capitalize on participation opportunities during routine hospital tasks, and use patient-centred communication.
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Misunderstanding medication dosage regimen instructions can lead to unintentional misuse of a prescribed medicine, non-adherence to providers' instructions, and other treatment-related issues. We aimed to evaluate the frequency of and factors associated with older patients' misunderstanding of medication dosage regimen instructions after consultation with a general practitioner. ⋯ The results showed that older people's misunderstandings of medication dosage regimen instructions after consultation with a general practitioner was greater than expected due to a range of factors, especially polypharmacy, poor literacy, poor memory, and having a job at the time of the interview. Health services and professionals should implement strategies to increase the quality of the guidance given to elderly individuals and to ensure their adherence to the regimen instructions of their medications.