Bmc Health Serv Res
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Bmc Health Serv Res · Sep 2019
Patient characteristics associated with being offered take home naloxone in a busy, urban emergency department: a retrospective chart review.
Overdose deaths can be prevented by distributing take home naloxone (THN) kits. The emergency department (ED) is an opportune setting for overdose prevention, as people who use opioids frequently present for emergency care, and those who have overdosed are at high risk for future overdose death. We evaluated the implementation of an ED-based THN program by measuring the extent to which THN was offered to patients presenting with opioid overdose. We analyzed whether some patients were less likely to be offered THN than others, to identify areas for program improvement. ⋯ In this real-world evaluation of an ED-based THN program, we observed that only half of patients with opioid overdose were offered THN. ED staff readily identify patients who use illegal opioids or experience a severe overdose as potentially benefitting from THN, but may miss others at high risk for future overdose. We recommend that hospital EDs provide additional guidance to staff to ensure that all eligible patients at risk of overdose have access to THN.
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Bmc Health Serv Res · Sep 2019
Dementia and patient safety in the community: a qualitative study of family carers' protective practices and implications for services.
Dementia is a cause of disability and dependency associated with high demands for health services and expected to have a significant impact on resources. Care policies worldwide increasingly rely on family caregivers to contribute to service delivery for older people, and the general direction of health care policy internationally is to provide care in the community, meaning most people will receive services there. Patient safety in primary care is therefore important for future care, but not yet investigated sufficiently when services are carried out in patients' homes. In particular, we know little about how family carers experience patient safety of older people with dementia in the community. ⋯ When family caregivers prevent harm and meet needs, some needs may be concealed or invisible to health professionals. To recognize all needs and provide effective, safe and person-centered care, health professionals need to recognize these preventive practices and seek to build a solid partnership with family carers.
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Bmc Health Serv Res · Sep 2019
Highlighting the need for de-implementation - Choosing Wisely recommendations based on clinical practice guidelines.
The Choosing Wisely campaign has spread to many countries. Methods for developing recommendations are inconsistent. We describe our process of developing such recommendations from a comprehensive national set of clinical practice guidelines (Current Care, CC) and the results of a one-year Choosing Wisely Finland project. ⋯ Choosing Wisely recommendations can be produced systematically from existing clinical practice guidelines. The rigorous methods of evidence-based medicine ensure high-quality recommendations. We welcome the use of our processes and methods describes in this article by other guideline-producing organizations.
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Bmc Health Serv Res · Sep 2019
Multicenter StudyPublic service motivation as a mediator of the relationship between job stress and presenteeism: a cross-sectional study from Chinese public hospitals.
Job stress is a strong indicator of presenteeism, but few studies have examined its diverse effects and mediators on presenteeism. This study explored the relationships between job stress, public service motivation (PSM) and presenteeism and how job stress and PSM influence presenteeism in a large national sample of Chinese healthcare workers. ⋯ The findings suggest that efforts to prevent presenteeism among healthcare workers in China should emphasize PSM improvement and reduction of hindrance stress.
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Bmc Health Serv Res · Aug 2019
Multicenter StudyImplementing eScreening technology in four VA clinics: a mixed-method study.
Technology-based self-assessment (TB-SA) benefits patients and providers and has shown feasibility, ease of use, efficiency, and cost savings. A promising TB-SA, the VA eScreening program, has shown promise for the efficient and effective collection of mental and physical health information. To assist adoption of eScreening by healthcare providers, we assessed technology-related as well as individual- and system-level factors that might influence the implementation of eScreening in four diverse VA clinics. ⋯ Despite some added work load for some staff and perceived lack of leadership support, eScreening was at least partially implemented in three clinics. The technology itself posed no barriers in any of the settings. An implementation strategy that accounts for increased work burden and includes accountability may help in future eScreening implementation efforts. Note. This abstract was previously published (e.g., Annals of Behavioral Medicine 53: S1-S842, 2019).