Qual Saf Health Care
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Qual Saf Health Care · Oct 2008
Systems ambiguity and guideline compliance: a qualitative study of how intensive care units follow evidence-based guidelines to reduce healthcare-associated infections.
Consistent compliance with evidence-based guidelines is challenging yet critical to patient safety. We conducted a qualitative study to explore the underlying causes for non-compliance with evidence-based guidelines aimed at preventing four types of healthcare-associated infections in the surgical intensive care unit (SICU) setting. ⋯ The concept of systems ambiguity is useful to understand causes of non-compliance with evidence-based guidelines aimed at reducing healthcare-associated infections. Multi-faceted interventions are needed to reduce different ambiguity types, hence to improve guideline compliance.
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Qual Saf Health Care · Oct 2008
Randomized Controlled Trial Comparative StudyTexting appointment reminders to repeated non-attenders in primary care: randomised controlled study.
Failure to attend appointments compromises health service efficiency. Despite considerable interest in using novel technologies to improve attendance, evidence from rigorously conducted controlled studies is lacking. ⋯ Although the intervention showed promise, we failed to demonstrate significant reduction in non-attendance rates, as a result of texting appointment reminders to patients who persistently fail to attend their general practice appointments.
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Qual Saf Health Care · Oct 2008
Comparative StudyImprovements in the quality of care and health outcomes with new stroke care units following implementation of a clinician-led, health system redesign programme in New South Wales, Australia.
Provision of evidence-based hospital stroke care is limited worldwide. In Australia, about a fifth of public hospitals provide stroke care units (SCUs). In 2001, the New South Wales (NSW) state government funded a clinician-led, health system redesign programme that included inpatient stroke services. Our objective was to determine the effects of this initiative for improving: (i) access to SCUs and care quality and (ii) health outcomes. ⋯ This distinctive SCU initiative was shown as effective for improving clinical practice and significantly reducing disability following stroke.
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Qual Saf Health Care · Oct 2008
Reporting of Clinical Adverse Events Scale: a measure of doctor and nurse attitudes to adverse event reporting.
To develop a validated measure of professionals' attitudes towards clinical adverse event reporting (CAER). ⋯ Initial development of an evidence-based, psychometrically rigorous measure of attitudes towards CAER has been reported. Following additional testing, RoCAES may be used to systematically elicit professionals' views about, and inform interventions to improve, reporting behaviour.
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Qual Saf Health Care · Oct 2008
The use of medical emergency teams in medical and surgical patients: impact of patient, nurse and organisational characteristics.
Medical emergency teams (METs) were developed to respond more rapidly to changes in patient condition. While effective, METs do not address events prior to the response. This study examined differences in patient, nurse, and organisational characteristics for 108 MET calls on five medical and five surgical units in a university hospital. ⋯ In a logistic regression model, shift and patient-unit-match (medical, surgical) were significant predictors of delays. The model correctly predicted 68% of delayed events. Study findings indicate that a combination of patient, nurse and organisational characteristics influence timely rescue.