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Chitha N, Ntsele N, Mabunda SA, Funani I, Swartbooi B, Mnyaka O, Thabede J, Tshabalala R, Pulido-Estrada GA, Nomatshila S, Chitha W. Exploring the Information Sources Consulted by Doctors at the Point of Care in Four Selected South African Referral Hospitals. Healthcare (Basel) 2023; 12:8. [PMID: 38200915 PMCID: PMC10778943 DOI: 10.3390/healthcare12010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND To provide an understanding of the clinical information sources consulted by teaching or referral hospital-based doctors in four South African provinces. METHODS A quantitative cross-sectional survey design was used. To identify provinces, hospitals, and participants, simple random sampling was adopted. This study targeted a total of 276 doctors from all the four hospitals working across different departments within the hospitals. This study was conducted in four selected South African public referral/teaching hospitals in four different provinces, namely Nelson Mandela Academic Hospital in the Eastern Cape province; Witbank Hospital in Mpumalanga province; Robert Mangaliso Sobukwe Hospital in Northern Cape province and lastly, Pietersburg Hospital in Limpopo province. RESULTS Overall, 221 doctors were surveyed. Doctors relied more on colleagues as formal and informal sources of information. They seldomly relied on newspapers, reference, and library books, or used hospital computers to access the internet. They seldomly attended training workshops organised by the district or provincial office. Protocols and clinical guidelines which are kept in the hospitals and easily accessible were often (27.9%) or always (51.1%) used. CONCLUSIONS Teaching hospitals need to strengthen information resources to ensure that even when colleagues are used as an information source, they are an accessible means to validate the correctness of the information provided.
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Affiliation(s)
- Nombulelo Chitha
- Health Systems Enablement and Innovation, University of the Witwatersrand, Johannesburg 2050, South Africa (B.S.); (O.M.); (J.T.)
| | - Nkanyiso Ntsele
- Health Systems Enablement and Innovation, University of the Witwatersrand, Johannesburg 2050, South Africa (B.S.); (O.M.); (J.T.)
| | - Sikhumbuzo A. Mabunda
- Health Systems Enablement and Innovation, University of the Witwatersrand, Johannesburg 2050, South Africa (B.S.); (O.M.); (J.T.)
- Department of Public Health, Walter Sisulu University, Mthatha 5117, South Africa
- School of Population Health, University of New South Wales, Sydney 2052, Australia
| | - Itumeleng Funani
- Health Systems Enablement and Innovation, University of the Witwatersrand, Johannesburg 2050, South Africa (B.S.); (O.M.); (J.T.)
| | - Buyiswa Swartbooi
- Health Systems Enablement and Innovation, University of the Witwatersrand, Johannesburg 2050, South Africa (B.S.); (O.M.); (J.T.)
| | - Onke Mnyaka
- Health Systems Enablement and Innovation, University of the Witwatersrand, Johannesburg 2050, South Africa (B.S.); (O.M.); (J.T.)
| | - Jahman Thabede
- Health Systems Enablement and Innovation, University of the Witwatersrand, Johannesburg 2050, South Africa (B.S.); (O.M.); (J.T.)
| | - Ruth Tshabalala
- Health Systems Enablement and Innovation, University of the Witwatersrand, Johannesburg 2050, South Africa (B.S.); (O.M.); (J.T.)
| | | | - Sibusiso Nomatshila
- Department of Public Health, Walter Sisulu University, Mthatha 5117, South Africa
| | - Wezile Chitha
- Health Systems Enablement and Innovation, University of the Witwatersrand, Johannesburg 2050, South Africa (B.S.); (O.M.); (J.T.)
- Department of Public Health, Walter Sisulu University, Mthatha 5117, South Africa
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Tan YXF, Lim STY, Lim JL, Ng TTM, Chng HT. Drug information-seeking behaviours of physicians, nurses and pharmacists: A systematic literature review. Health Info Libr J 2023; 40:125-168. [PMID: 36655603 DOI: 10.1111/hir.12472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/09/2022] [Accepted: 11/30/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND Medication use typically involves physicians prescribing, pharmacists reviewing, and nurses administering medications to patients. Drug information (DI) is often required during the process, with the various health care professionals (HCPs) seeking information differently according to their needs and familiarity with various resources. OBJECTIVE This systematic literature review aims to evaluate studies on drug information-seeking behaviour (ISB) of physicians, nurses and pharmacists to ascertain their DI needs, DI sources used, facilitators and barriers to DI-seeking. METHODS A systematic search was conducted on PubMed, Embase.com, Scopus, PsycINFO, CINAHL and Cochrane Library to identify eligible primary research articles published between January 2000 and May 2020. RESULTS The reviewed studies (N = 48) revealed that HCPs have a wide range of DI needs, with the top needs being similar across the three HCPs. Information sources used most often by all three groups were tertiary, followed by human and primary sources. Factors relating to the source characteristics were the most reported facilitators and barriers to DI-seeking. Some differences in drug ISB were also identified. CONCLUSION Our findings can also guide information providers and educators to optimize information provision. It may also facilitate effective communication amongst HCPs when obtaining DI from or providing DI to one another.
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Affiliation(s)
- Yu Xin Fiona Tan
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Suzanne Tze Yin Lim
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Jun Liang Lim
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | | | - Hui Ting Chng
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
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Bankes DL, Schamp RO, Knowlton CH, Bain KT. Prescriber-Initiated Engagement of Pharmacists for Information and Intervention in Programs of All-Inclusive Care for the Elderly. PHARMACY 2020; 8:pharmacy8010024. [PMID: 32098064 PMCID: PMC7151697 DOI: 10.3390/pharmacy8010024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 02/13/2020] [Accepted: 02/18/2020] [Indexed: 02/08/2023] Open
Abstract
Little is known about the types of drug information inquiries (DIIs) prescribers caring for older adults ask pharmacists during routine practice. The objective of this research was to analyze the types of DIIs prescribing clinicians of Programs of All-Inclusive Care for the Elderly (PACE) made to clinical pharmacists during routine patient care. This was a retrospective analysis of documented pharmacists' encounters with PACE prescribers between March through December, 2018. DIIs were classified using a developed taxonomy that describes prescribers' motivations for consulting with pharmacists and their drug information needs. Prescribers made 414 DIIs during the study period. Medication safety concerns motivated the majority of prescribers' inquiries (223, 53.9%). Inquiries received frequently involved modifying drug therapy (94, 22.7%), identifying or resolving adverse drug events (75, 18.1%), selecting or adjusting doses (61, 14.7%), selecting new drug therapies (57, 13.8%), and identifying or resolving drug interactions (52, 12.6%). Central nervous system medications (e.g., antidepressants and opioids), were involved in 38.6% (n = 160) of all DIIs. When answering DIIs, pharmacists made 389 recommendations. Start alternative medications (18.0%), start new medications (16.7%), and change doses (12.1%) were the most frequent recommendations rendered. Prescribers implemented at least 79.3% (n = 268) of recommendations based on pharmacy records (n = 338 verifiable recommendations). During clinical practice, PACE prescribers commonly ask pharmacists a variety of DIIs, largely related to medication safety concerns. In response to these DIIs, pharmacists provide medication management recommendations, which are largely implemented by prescribers.
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Noma H, Naito C, Tada M, Yamanaka H, Takemura T, Nin K, Yoshihara H, Kuroda T. Prototyping Sensor Network System for Automatic Vital Signs Collection. Methods Inf Med 2018; 52:239-49. [DOI: 10.3414/me12-01-0096] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Accepted: 12/04/2012] [Indexed: 11/09/2022]
Abstract
SummaryObjective: Development of a clinical sensor network system that automatically collects vital sign and its supplemental data, and evaluation the effect of automatic vital sensor value assignment to patients based on locations of sensors.Methods: The sensor network estimates the data-source, a target patient, from the position of a vital sign sensor obtained from a newly developed proximity sensing system. The proximity sensing system estimates the positions of the devices using a Bluetooth inquiry process. Using Bluetooth access points and the positioning system newly developed in this project, the sensor network collects vital sign and its 4W (who, where, what, and when) supplemental data from any Blue-tooth ready vital sign sensors such as Continua-ready devices. The prototype was evaluated in a pseudo clinical setting at Kyoto University Hospital using a cyclic paired comparison and statistical analysis.Results: The result of the cyclic paired analysis shows the subjects evaluated the proposed system is more effective and safer than POCS as well as paper-based operation. It halves the times for vital signs input and eliminates input errors. On the other hand, the prototype failed in its position estimation for 12.6% of all attempts, and the nurses overlooked half of the errors. A detailed investigation clears that an advanced interface to show the system’s “confidence”, i.e. the probability of estimation error, must be effective to reduce the oversights.Conclusions: This paper proposed a clinical sensor network system that relieves nurses from vital signs input tasks. The result clearly shows that the proposed system increases the efficiency and safety of the nursing process both subjectively and objectively. It is a step toward new generation of point of nursing care systems where sensors take over the tasks of data input from the nurses.
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Arguello B, Salgado TM, Laekeman G, Fernandez-Llimos F. Development of a tool to assess the completeness of drug information sources for health care professionals: A Delphi study. Regul Toxicol Pharmacol 2017; 90:87-94. [PMID: 28842337 DOI: 10.1016/j.yrtph.2017.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 08/17/2017] [Accepted: 08/20/2017] [Indexed: 11/27/2022]
Abstract
The aim of this study was to create a standard set of essential drug information items as a tool to assess the completeness of any type of drug information source, regardless of its length, using a Delphi consensus panel of European health care professionals. A compilation of drug-related information items was performed by searching several resources for health care professionals and a final list of 162 items was obtained. Fifty-seven experts in drug information from 23 different European countries were invited to participate in a three-round Delphi technique to obtain consensus on items considered essential and non-essential content of information. Consensus for the first, second, and third rounds was defined as ≥90%, ≥80%, and ≥75% agreement, respectively. Of the 57 experts invited, 32 completed the first round, 27 the second, and 29 the third. Consensus was achieved for 28.3% of the items in the first round, 49.3% in the second, and 58.3% in the third. The final cumulative consensus was 67.7% (n = 126) for items considered essential and 16.1% (n = 30) for items considered non-essential. The final tool obtained to assess the completeness of drug information sources was composed by 126 essential items grouped into 11 sections. This tool allows for the comparison of different information sources for the same medicine and the information content for different medicines in the same source.
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Affiliation(s)
- Blanca Arguello
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, 1649-003 Lisbon, Portugal
| | - Teresa M Salgado
- Department of Pharmacotherapy & Outcomes Science, Virginia Commonwealth University School of Pharmacy, 410 N 12th Street P.O. Box 980533, Richmond, VA 23298-0533, United States
| | - Gert Laekeman
- Clinical Pharmacology and Pharmacotherapeutics, Faculty of Pharmaceutical Sciences, KU Leuven, O&N II, Herestraat 49, PO Box 521, 3000 Leuven, Belgium
| | - Fernando Fernandez-Llimos
- Research Institute for Medicines (iMed.ULisboa), Department of Social-Pharmacy, Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal.
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Minard LV, Corkum A, Sketris I, Fisher J, Zhang Y, Saleh A. Trends in Statin Use in Seniors 1999 to 2013: Time Series Analysis. PLoS One 2016; 11:e0158608. [PMID: 27434392 PMCID: PMC4951112 DOI: 10.1371/journal.pone.0158608] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 06/17/2016] [Indexed: 01/24/2023] Open
Abstract
PURPOSE To examine HMG-CoA reductase inhibitor (statin) drug dispensing patterns to Nova Scotia Seniors' Pharmacare program (NSSPP) beneficiaries over a 14-year period in response to: 1) rosuvastatin market entry in 2003, 2) JUPITER trial publication in 2008, and 3) generic atorvastatin availability in 2010. METHODS All NSSPP beneficiaries who redeemed at least one prescription for a statin from April 1, 1999 to March 31, 2013 were included. Aggregated, anonymous monthly prescription counts were extracted by the Nova Scotia Department of Health and Wellness (Nova Scotia, Canada) and changes in dispensing patterns of statins were measured. Data were analyzed using descriptive analyses and interrupted time series methods. RESULTS The percentage of NSSPP beneficiaries dispensed any statin increased from 5.3% in April 1999 to 20.7% in March 2013. In 1999, most NSSPP beneficiaries were dispensed either simvastatin (29.5%) or atorvastatin (28.7%). When rosuvastatin was added to the NSSPP Formulary in August 2003, prescriptions dispensed for simvastatin, lovastatin, pravastatin, and fluvastatin declined significantly (slope change, -0.0027; 95% confidence interval (CI), (-0.0046, -0.0009)). This significant decline continued following the publication of JUPITER (level change, -0.1974; 95% CI, (-0.2991, -0.0957)) and the availability of generic atorvastatin (level change, -0.2436; 95% CI, (-0.3314, -0.1558)). Atorvastatin was not significantly affected by any of the three interventions, although it maintained an overall decreasing trend. Only upon the availability of generic atorvastatin did the upward trend in rosuvastatin use decrease significantly (slope change, -0.0010, 95% CI, (-0.0015, -0.0005)). CONCLUSIONS The type and rate of statins dispensed to NSSPP beneficiaries changed from 1999 to 2013 in response to the availability of new agents and publication of the JUPITER trial. The overall proportion of NSSPP beneficiaries dispensed a statin increased approximately 4-fold during the study period. In 2013, rosuvastatin was the most commonly dispensed statin (44.1%) followed by atorvastatin (39.1%).
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Affiliation(s)
- Laura V. Minard
- College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Amber Corkum
- Statistical Consulting Unit, Acadia University, Wolfville, Nova Scotia, Canada
| | - Ingrid Sketris
- College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Judith Fisher
- Nova Scotia Department of Health and Wellness, Halifax, Nova Scotia, Canada
| | - Ying Zhang
- Statistical Consulting Unit, Acadia University, Wolfville, Nova Scotia, Canada
| | - Ahmed Saleh
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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Pollmann AS, Murphy AL, Bergman JC, Gardner DM. Deprescribing benzodiazepines and Z-drugs in community-dwelling adults: a scoping review. BMC Pharmacol Toxicol 2015; 16:19. [PMID: 26141716 PMCID: PMC4491204 DOI: 10.1186/s40360-015-0019-8] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 06/23/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Long-term sedative use is prevalent and associated with significant morbidity, including adverse events such as falls, cognitive impairment, and sedation. The development of dependence can pose significant challenges when discontinuation is attempted as withdrawal symptoms often develop. We conducted a scoping review to map and characterize the literature and determine opportunities for future research regarding deprescribing strategies for long-term benzodiazepine and Z-drug (zopiclone, zolpidem, and zaleplon) use in community-dwelling adults. METHODS We searched PubMed, Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, CINAHL, TRIP, and JBI Ovid databases and conducted a grey literature search. Articles discussing methods for deprescribing benzodiazepines or Z-drugs in community-dwelling adults were selected. RESULTS Following removal of duplicates, 2797 articles were reviewed for eligibility. Of these, 367 were retrieved for full-text assessment and 139 were subsequently included for review. Seventy-four (53%) articles were original research, predominantly randomized controlled trials (n = 52 [37%]), whereas 58 (42%) were narrative reviews and seven (5%) were guidelines. Amongst original studies, pharmacologic strategies were the most commonly studied intervention (n = 42 [57%]). Additional deprescribing strategies included psychological therapies (n = 10 [14%]), mixed interventions (n = 12 [16%]), and others (n = 10 [14%]). Behaviour change interventions were commonly combined and included enablement (n = 56 [76%]), education (n = 36 [47%]), and training (n = 29 [39%]). Gradual dose reduction was frequently a component of studies, reviews, and guidelines, but methods varied widely. CONCLUSIONS Approaches proposed for deprescribing benzodiazepines and Z-drugs are numerous and heterogeneous. Current research in this area using methods such as randomized trials and meta-analyses may too narrowly encompass potential strategies available to target this phenomenon. Realist synthesis methods would be well suited to understand the mechanisms by which deprescribing interventions work and why they fail.
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Affiliation(s)
- André S Pollmann
- Faculty of Medicine, Dalhousie University, Mail Box #259, 5849 University Avenue, Room C-125, PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Andrea L Murphy
- College of Pharmacy and Department of Psychiatry, Dalhousie University, 5968 College St, PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Joel C Bergman
- College of Pharmacy and Department of Psychiatry, Dalhousie University, 5968 College St, PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - David M Gardner
- Department of Psychiatry and College of Pharmacy, Dalhousie University, QEII HSC, AJLB 7517, 5909 Veterans' Memorial Lane, Halifax, NS, B3H 2E2, Canada.
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Ricks E, ten Ham W. Health information needs of professional nurses required at the point of care. Curationis 2015; 38. [PMID: 26244456 PMCID: PMC6091809 DOI: 10.4102/curationis.v38i1.1432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 01/21/2015] [Accepted: 03/23/2015] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Professional nurses work in dynamic environments and need to keep up to date with relevant information for practice in nursing to render quality patient care. Keeping up to date with current information is often challenging because of heavy workload, diverse information needs and the accessibility of the required information at the point of care. OBJECTIVES The aim of the study was to explore and describe the information needs of professional nurses at the point of care in order to make recommendations to stakeholders to develop a mobile library accessible by means of smart phones when needed. METHOD The researcher utilised a quantitative, descriptive survey design to conduct this study. The target population comprised 757 professional nurses employed at a state hospital. Simple random sampling was used to select a sample of the wards, units and departments for inclusion in the study. A convenience sample of 250 participants was selected. Two hundred and fifty structured self-administered questionnaires were distributed amongst the participants. Descriptive statistics were used to analyse the data. RESULTS A total of 136 completed questionnaires were returned. The findings highlighted the types and accessible sources of information. Information needs of professional nurses were identified such as: extremely drug-resistant tuberculosis, multi-drug-resistant tuberculosis, HIV, antiretrovirals and all chronic lifestyle diseases. CONCLUSION This study has enabled the researcher to identify the information needs required by professional nurses at the point of care to enhance the delivery of patient care. The research results were used to develop a mobile library that could be accessed by professional nurses.
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Affiliation(s)
- Esmeralda Ricks
- Department of Nursing Science, Nelson Mandela Metropolitan University.
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Tahamtan I, Tavassoli Farahi M, Afshar AS, Baradaran HR. Drug information seeking behaviours of health care professionals in Iran. ACTA ACUST UNITED AC 2015. [DOI: 10.1108/nlw-06-2014-0070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The purpose of this paper is to list the resources that Iranian health-care professionals used to access drug-related information, to know the features and types of drug information resources which were much more important for health-care professionals, the problems they encountered in seeking drug information and the way they organized and re-found the information that they had retrieved. Drug-related queries are one of the most common types of questions in medical settings.
Design/methodology/approach
– This was a descriptive-analytical study conducted in Iran during 2014. The data collection tool was a self-designed questionnaire. Data analysis was conducted using Statistical Package for Social Sciences. Descriptive statistics and chi-square test were used to analyse the data and examine the research hypothesis.
Findings
– Participants used books, drug manuals, search engines and medical databases more frequently, and less than half of them consulted colleagues to acquire drug-related information for clinical, educational and research purposes. Handheld computers were used by most participants to access and store drug information. Lack of access to drug information and lack of enough time were the main obstacles in seeking drug information. A significant association (p value = 0.024) was detected between organizing and re-finding information for future uses.
Originality/value
– This study investigated drug information-seeking behaviours of health-care professionals and the way they managed this information in a developing country that lacks necessary information technology infrastructures. Training programmes are required to help health-care professionals to find and access reliable and up-to-date drug information resources and to more easily re-find the found drug information for future uses.
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Abstract
This study examines the use of smartphones by Alabama Advanced Practice Nurses to find information to address clinical questions and seeks to describe the types of questions answered using smartphones; barriers to information seeking; apps and online resources perceived as most helpful; and training/resource needs. Information collected in this study can be used by libraries that serve nursing students to develop training and resources to assist both nursing students and practicing nurses to become more efficient and effective information seekers.
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Affiliation(s)
- Adelia Grabowsky
- a Ralph Brown Draughon Library , Auburn University , Auburn , Alabama , USA
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Self-reported use of handheld computers: a survey of Nova Scotia pharmacists. JOURNAL OF THE CANADIAN HEALTH LIBRARIES ASSOCIATION 2014. [DOI: 10.5596/c11-055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: With an ever-increasing array of pharmaceutical and biomedical products and literature, health professionals including pharmacists struggle to obtain, evaluate, and apply relevant information. Handheld computers provide pharmacists with mobile access to evidence-informed medical information, decision support tools, and the ability to monitor therapeutic outcomes at the point of care. There is limited literature on the usage of this technology by Canadian pharmacists. The objective of this survey was to determine the scope and nature of handheld computer use by Nova Scotia pharmacists. Method: In 2008, Nova Scotia pharmacists were contacted with a written survey. Descriptive statistics were used to compare users and non-users. Multivariate regression analysis was used to determine demographic and pharmacy practice variables that might be associated with pharmacists’ use of handheld computers. Results: The survey was returned by 296 pharmacists (27.7%). Handheld computers were reported to be used by 51% of respondents. Those respondents who have been in practice longer were less likely to adopt handheld computer use (adjusted OR = 0.97, 95% CI = 0.94–0.99, p = 0.01). Barriers and facilitators to usage were explored. More than two-thirds of pharmacists who had not yet used handheld computers perceived a future value for these devices within their practice. Discussion: Pharmacists are adopting the use of handheld computers. With enhanced clinical practice opportunities for pharmacists including independent prescribing, these tools may offer needed functionality. Further work is required to understand the value of handheld computers as information resources, which may improve the effectiveness and efficiency of patient care.
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Farag A, Garg AX, Li L, Jain AK. Dosing Errors in Prescribed Antibiotics for Older Persons With CKD: A Retrospective Time Series Analysis. Am J Kidney Dis 2014; 63:422-8. [DOI: 10.1053/j.ajkd.2013.09.009] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 09/11/2013] [Indexed: 01/23/2023]
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Lohmann K, Ferber J, Send AFJ, Haefeli WE, Seidling HM. Inappropriate crushing information on ward lists: cytotoxic drugs, capsules, and modified release formulations are gravely neglected. Eur J Clin Pharmacol 2014; 70:565-73. [DOI: 10.1007/s00228-013-1638-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 12/29/2013] [Indexed: 01/07/2023]
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Worldwide analysis of factors associated with medicines compendia publishing. Int J Clin Pharm 2013; 35:386-92. [PMID: 23536106 DOI: 10.1007/s11096-012-9744-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 12/18/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Medicines compendia, also called formularies, are the most commonly used drug information source among health care professionals. OBJECTIVE The aim was to identify the countries publishing medicines compendia and the socio-demographic factors associated to this fact. Additionally, we sought to determine the use of foreign compendia in countries lacking their own. SETTING Global web-based survey. METHOD Healthcare practitioners and researchers from 193 countries worldwide were invited to complete a web-based survey. The questionnaire investigated the existence of a national compendium, or the use of foreign compendia in the absence of one. Demographic and socioeconomic variables were used to predict compendia publishing through a multivariate analysis. MAIN OUTCOME MEASURE Existence of national medicines compendia and foreign compendia used. RESULTS Professionals from 132 countries completed the survey (response rate at a country level 68.4%, comprising 90.9% global population). Eighty-four countries (63.6%) reported publishing a medicines compendium. In the multivariate analysis, only two covariates had significant association with compendia publishing. Being a member of the Organisation for the Economic Cooperation and Development was the only variable positively associated with compendia publishing (OR = 37.5; 95% CI = 2.3:599.8). In contrast, the countries that listed French as an official language were less likely to publish a compendium (OR = 0.07; 95% CI = 0.007:0.585). Countries without national compendia reported using the British National Formulary most commonly, followed by the Dictionnaire Vidal. CONCLUSION Publication of medicines compendia is associated with socio-economic development. Countries lacking a national compendium, use foreign compendia from higher-income countries. Creating an international medicines compendium under the leadership of the World Health Organisation, rather than merely a 'model', would reduce the risks of using information sources not-adapted to the necessities of developing countries.
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KURODA T, NAKASHIMA N, KANEDA M, SATO K, OHBOSHI N, OKADA A, OKAMOTO K, YOSHIHARA H, AKIYAMA T. Evaluating the Workload Reduction of Automatic Vital Data Transmission. ADVANCED BIOMEDICAL ENGINEERING 2013. [DOI: 10.14326/abe.2.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Tomohiro KURODA
- Division of Medical Information Technology and Administration Planning, Kyoto University Hospital
| | | | | | - Kikue SATO
- Graduate School of Health Science, Kyoto University
| | | | | | - Kazuya OKAMOTO
- Division of Medical Information Technology and Administration Planning, Kyoto University Hospital
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Murphy A, Gardner D, Kutcher S, Davidson S, Manion I. Collaborating with youth to inform and develop tools for psychotropic decision making. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2010; 19:256-63. [PMID: 21037916 PMCID: PMC2962538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Youth oriented and informed resources designed to support psychopharmacotherapeutic decision-making are essentially unavailable. This article outlines the approach taken to design such resources, the product that resulted from the approach taken, and the lessons learned from the process. METHODS A project team with psychopharmacology expertise was assembled. The project team reviewed best practices regarding medication educational materials and related tools to support decisions. Collaboration with key stakeholders who were thought of as primary end-users and target groups occurred. A graphic designer and a plain language consultant were also retained. RESULTS Through an iterative and collaborative process over approximately 6 months, Med Ed and Med Ed Passport were developed. Literature and input from key stakeholders, in particular youth, was instrumental to the development of the tools and materials within Med Ed. A training program utilizing a train-the-trainer model was developed to facilitate the implementation of Med Ed in Ontario, which is currently ongoing. CONCLUSION An evidence-informed process that includes youth and key stakeholder engagement is required for developing tools to support in psychopharmacotherapeutic decision-making. The development process fostered an environment of reciprocity between the project team and key stakeholders.
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Affiliation(s)
- Andrea Murphy
- School of Nursing, Dalhousie University, Halifax, Nova Scotia
- Sun Life Financial Chair in Adolescent Mental Health, Dalhousie University, Halifax, Nova Scotia
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia
| | - David Gardner
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia
| | - Stan Kutcher
- Sun Life Financial Chair in Adolescent Mental Health, Dalhousie University, Halifax, Nova Scotia
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia
- IWK Health Centre, Halifax, Nova Scotia
- WHO Collaborating Centre, Dalhousie University, Halifax, Nova Scotia
| | - Simon Davidson
- The Provincial Centre of Excellence for Child and Youth Mental Health at the Children’s Hospital of Eastern Ontario, Ottawa, Ontario
- Department of Psychiatry, University of Ottawa, Ottawa
| | - Ian Manion
- The Provincial Centre of Excellence for Child and Youth Mental Health at the Children’s Hospital of Eastern Ontario, Ottawa, Ontario
- School of Psychology, University of Ottawa, Ottawa
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Polen HH, Clauson KA, Thomson W, Zapantis A, Lou JQ. Evaluation of nursing-specific drug information PDA databases used as clinical decision support tools. Int J Med Inform 2009; 78:679-87. [PMID: 19640779 DOI: 10.1016/j.ijmedinf.2009.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 05/06/2009] [Accepted: 06/19/2009] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nursing is arguably the most organizationally diverse healthcare profession. Educational backgrounds may vary, even among similarly credentialed nurses. Drug information databases used as clinical decision support tools can improve access to pharmacologic information at point-of-care when housed on personal digital assistants. They may also help address the disparity in drug information and pharmacology education between nurses. OBJECTIVES To evaluate nursing-specific drug information database content on personal digital assistants (PDAs). METHODS Seven nursing-specific PDA databases were evaluated for scope (absence or presence of an answer) and completeness (three-point scale) via the use of 80 general category and 80 subspecialty drug information questions. Erroneous information was also tracked. Individual scope and completeness scores were delineated by rank order and chi square was performed to determine differences in scope and completeness scores between the databases. RESULTS Davis's Drug Guide for Nurses (DDGN) and Nursing Lexi-Drugs (NLD) tied for the highest scores for scope, including each answering 72.5% of the 160 evaluation questions. No significant differences existed between their scores and those earned by Nursing2008 Drug Handbook (p<0.05). The highest scores for completeness were earned by NLD with 58.1% and DDGN at 57.1%. Saunders Nursing Drug Handbook was the only database that showed a significantly lower score in completeness as compared to the other six databases (p<0.05). A 4.2% overall error rate was found among database answers. DISCUSSION Significant differences were found among the performances in the databases evaluated in this study for their ability to answer commonly encountered drug information issues in nursing practice. All databases contained some erroneous information and even the top performers failed to provide answers to more than one-fourth of the questions posed. The availability of accurate and timely drug information at point-of-care can play a vital role in patient management and outcomes, but current resources that are available need to be improved.
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Affiliation(s)
- Hyla H Polen
- Nova Southeastern University, College of Pharmacy, Palm Beach Gardens, FL, USA.
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Lindquist AM, Johansson PE, Petersson GI, Saveman BI, Nilsson GC. The use of the Personal Digital Assistant (PDA) among personnel and students in health care: a review. J Med Internet Res 2008; 10:e31. [PMID: 18957381 PMCID: PMC2629360 DOI: 10.2196/jmir.1038] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2008] [Revised: 07/02/2008] [Accepted: 09/23/2008] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Health care personnel need access to updated information anywhere and at any time, and a Personal Digital Assistant (PDA) has the potential to meet these requirements. A PDA is a mobile tool which has been employed widely for various purposes in health care practice, and the level of its use is expected to increase. Loaded with suitable functions and software applications, a PDA might qualify as the tool that personnel and students in health care need. In Sweden today, despite its leadership role in mobile technologies, PDAs are not commonly used, and there is a lack of suitable functions and software applications. OBJECTIVE The aim of the present review was to obtain an overview of existing research on the use of PDAs among personnel and students in health care. METHODS The literature search included original peer-reviewed research articles written in English and published from 1996 to 2008. All study designs were considered for inclusion. We excluded reviews and studies focusing on the use of PDAs in classroom situations. From March 2006 to the last update in May 2008, we searched PubMed, CINAHL, Cochrane, IngentaConnect, and a local search engine (ELIN@Kalmar). We conducted a content analysis, using Nielsen's Model of System Acceptability as a theoretical framework in structuring and presenting the results. RESULTS From the 900 references initially screened, 172 articles were selected and critically assessed until 48 articles remained. The majority originated in North-America (USA: n=24, Canada: n=11). The categories which emerged from our content analysis coincided to a certain extent to Nielsen's Model of System Acceptability (social and practical acceptability), including usefulness (utility and usability) subcategories such as learnability, efficiency, errors, and satisfaction. The studies showed that health care personnel and students used PDAs in patient care with varied frequency. Most of the users were physicians. There is some evidence that the use of a PDA in health care settings might improve decision-making, reduce the numbers of medical errors, and enhance learning for both students and professionals, but the evidence is not strong, with most studies being descriptive, and only 6 randomized controlled trials. Several special software programs have been created and tested for PDAs, and a wide range of situations for their use have been reported for different patient groups. Drug and medical information were commonly accessed by PDA users, and the PDA was often viewed as the preferred tool when compared to paper-based documents. Some users regarded the PDA easy to operate, while others found it difficult in the beginning. CONCLUSIONS This overview of the use of PDAs revealed a positive attitude towards the PDA, which was regarded as a feasible and convenient tool. The possibility of immediate access to medical information has the potential to improve patient care. The PDA seems to be a valuable tool for personnel and students in health care, but there is a need for further intervention studies, randomized controlled trials, action research, and studies with various health care groups in order to identify its appropriate functions and software applications.
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