To see the other types of publications on this topic, follow the link: Admission Testing Program.
Journal articles on the topic 'Admission Testing Program'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Admission Testing Program.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Briihl, Deborah S., and David T. Wasieleski. "The GRE Analytical Writing Test: Description and Utilization." Teaching of Psychology 34, no. 3 (July 2007): 191–93. http://dx.doi.org/10.1080/00986280701498632.
Full textAbstract:
We surveyed graduate programs to see how they use the Graduate Record Examination Analytic Writing (GRE-AW) Test. Only 35% of the graduate programs that responded use the GRE-AW test in their admission policy; of the programs not using it, most do not plan to do so. The programs using the GRE-AW rated it as medium or low in importance in their admission decisions. Few programs have cutoff scores. Approximately 8% reported using an initial validation study; about half reported considering or running an ongoing validation study. We urge program coordinators to evaluate the potential benefits of the GRE-AW as part of admissions decisions and the Educational Testing Service to help coordinators do so.
2
Harris, Richard L., Eugene V. Boisaubin, Pamela D. Salyer, and Denise F. Semands. "Evaluation of a Hospital Admission HIV Antibody Voluntary Screening Program." Infection Control & Hospital Epidemiology 11, no. 12 (December 1990): 628–34. http://dx.doi.org/10.1086/646112.
Full textAbstract:
AbstractVoluntary screening for the presence of human immunodeficiency virus (HIV) is recommended by the healthcare profession. The optimal settings to accomplish screening have not been established. We evaluated an admission HIV screening program in a large private hospital to assess advantages and disadvantages in this setting. In a three-month study period, 4,535 of 8,868 patients (51%) admitted to the hospital agreed to HIV testing. Serum specimens from 500 patients who refused testing were blindly, anonymously tested. The seroprevalence of the patients agreeing to (0.26%) and refusing (0.60%) testing was not statistically different (p = .12). There were 12 HIV cases discovered; ten (83%) of these were known to be in a high-risk group at the time of admission. Eighty-five percent of patients interviewed were in favor of this screening program. Difficulties associated with confidentiality or consent were not evident. Calculated charges of testing for each HIV case discovery was $14,550. There was no evidence that this screening program provided for a more effective infection control policy to prevent nosocomial HIV transmission. A hospital admission HIV screening program can be implemented can meet with favorable patient opinion and can detect previously unknown HIV-positive patients. Hospitals are an efficient and practical setting for HIV testing. The benefit of this program appears to be greater for the patient than hospital or healthcare worker. Cost-benefit analyses will identify optimal candidates to be screened in different hospital populations.
3
Bettinger, Julie A., Kathryn Wills, Nicole Le Saux, David W. Scheifele, Scott A. Halperin, and Wendy Vaudry. "Heterogeneity of Rotavirus Testing and Admitting Practices for Gastroenteritis among 12 Tertiary Care Pediatric Hospitals: Implications for Surveillance." Canadian Journal of Infectious Diseases and Medical Microbiology 22, no. 1 (2011): 15–18. http://dx.doi.org/10.1155/2011/656404.
Full textAbstract:
BACKGROUND: The Canadian Immunization Monitoring Program, ACTive (IMPACT) surveillance for rotavirus relies on monitoring hospital admissions. Because a diagnosis of rotavirus is not necessary for treatment purposes, and rotavirus is not a reportable disease, wide variation may exist in the admitting and testing practices for this disease. From 2005 to 2007, the number of rotavirus admissions differed significantly among IMPACT centres, and this variation could not be explained by population differences alone. Understanding this variation is important when interpreting surveillance data and estimating the cost-effectiveness of rotavirus vaccination programs.METHODS: Key informant interviews were conducted with pediatric infectious disease physicians and IMPACT nurse monitors involved with rotavirus surveillance to obtain in-depth information about rotavirus testing and admitting practices at each of the 12 IMPACT centres.RESULTS: A total of 18 of 24 interviews were completed, with at least one interview conducted with physicians and/or nurses at each centre. Four major differences were identified among the centres: case-identification methods, admission definitions, admission criteria and testing criteria. The criteria for admitting and testing patients as well as which patients were defined as admissions had the greatest influence on case totals.DISCUSSION: The present study found that differences in admitting and testing practices may contribute to significant differences in rotavirus admission totals. Given these differences, caution should be used when using local case estimates for cost-effectiveness analyses and immunization program decisions. The present study illustrates that understanding the factors that influence the identification of a disease is important when interpreting and applying surveillance data.
4
Power, Steve, and Arif Kamal. "Developing and testing a novel hospital readmission score for patients with cancer." Journal of Clinical Oncology 36, no. 30_suppl (October 20, 2018): 244. http://dx.doi.org/10.1200/jco.2018.36.30_suppl.244.
Full textAbstract:
244 Background: Up to 50% of cancer patients experience an unplanned hospitalization. This represents opportunities for both improvements in quality of care and utilization of low value resources. Hospital readmission scores, to best target post-discharge navigation and follow-up, are needed yet not widely available. Methods: We conducted a retrospective cohort study among oncology patients admitted to Duke University Hospitals in 2015. The readmissions risk test model was built using multivariate analysis to identify and ‘weight’ four key readmission predictors. The model was subsequently analyzed in a validation data set using 2016 & 2017 admission data. Results: Of the 4987 admissions in 2015, 55% were male, 73% were Caucasian, and mean age was 61 (SD 14.1 years). Common cancers were GI (31%), Thoracic (27%) and GU (24%). Factors used to build the readmission predictor model based on the relative Odds Ratios were race (1), length of stay (1), discharge disposition (2), and previous admission with < 90 days (2) or 91-180 days (1). The patient cohort used to test the model had 1926 admissions and each were assigned a point value according to the model specifications, see Figure 1. We found significant differences in risk for readmission among differences in scores (p < 0.05). We have subsequently launched a post-discharge navigation program, with frequency of contacts dictated by readmission risk from the model. Conclusions: Predictor models in the oncology setting can identify combinations of factors that are associated with readmission. Programs that integrate such models may identify cancer patients at high risk of readmission and thus tailor a personalized approach to preventing a subsequent admission.[Table: see text]
5
O'Neill, Lotte Dyhrberg, Mette Krogh Christensen, Maria Cecilie Vonsild, and Birgitta Wallstedt. "Program specific admission testing and dropout for sports science students: a prospective cohort study." Dansk Universitetspædagogisk Tidsskrift 9, no. 17 (September 1, 2014): 55–70. http://dx.doi.org/10.7146/dut.v9i17.15540.
Full textAbstract:
Recent research in medical education suggests that program specific admission testing could have a protective effect against early dropout. Little is known about the effect of program specific admission testing on dropout in other areas of higher education. The aim of this paper was to examine if admission strategy was also independently associated with dropout for sports science students in a university setting. The study design was a prospective cohort study with a 2 year follow-up. The population was 449 sports science students admitted to a university in the years 2002-2007. The analysis used was multivariate logistic regression and the predictors examined were: admission group (grade-based or admission tested) as well as educational and socio-demographic variables. The outcome was dropout within 2 years of study start. Admission testing offered superior protection against dropout compared to grade-based admission. This result may fit with elements of previous dropout theory, student-environment fit theory and perhaps also with self-efficacy theory. Nyere forskning inden for medicinsk uddannelse indikerer at uddannelsesspecifikke optagelsesprøver kan have en beskyttende effekt i forhold til tidligt studiefrafald, men for andre universitetsuddannelser end Medicin synes denne sammenhæng endnu ikke at være blevet grundigt belyst. Formålet med dette studie var derfor at undersøge, om optagelsesprøver også beskyttede mod tidligt frafald blandt idrætsstuderende på universitetet. Studiedesignet var et prospektivt kohortestudie med to års opfølgning. Populationen var 449 idrætsstuderende, som blev optaget på Syddansk Universitet i årene 2002-2007. Data blev analyseret med multivariat logistisk regression, og følgende typer af prædiktorer for frafald blev undersøgt: Optagelseskvote (kvote 1 eller kvote 2 udprøvede), andre uddannelsesrelaterede variable samt udvalgte socio-demografiske variable. Effektmålet var studiestatus (frafaldet/ikke-frafaldet) to år efter studiestart. Vi fandt, at optagelsesprøver (kvote 2 udprøvning) virkede beskyttende i forhold til tidligt studiefrafald på idrætsstudiet sammenlignet med karakterbaseret optagelse (kvote 1 optagelse). Dette resultat kunne være i overensstemmelse med dele af allerede eksisterende frafaldsteorier, student-environment fit teori og måske også med self-efficacy teori.
6
Dowling, Bill. "Admission To The Master Of Business Administration Program: An Alternative For Savannah State University." American Journal of Business Education (AJBE) 2, no. 1 (January 1, 2009): 31–36. http://dx.doi.org/10.19030/ajbe.v2i1.4018.
Full textAbstract:
Traditionally, graduate programs in business administration have heavily relied on the Graduate Management Aptitude Test prepared and administered by the Educational Testing Service in the decision to admit a candidate to the program. The purpose of this paper is to review the literature regarding the statistical validity and statistical independence of the GMAT. In light of the outcome of this review, an alternative admissions process is proposed.
7
Glotzbecker, Brett, Deborah Yolin-Raley, Sara Close, Robert Soiffer, Joseph H. Antin, Joseph O. Jacobson, and Edwin Alyea. "Reducing unnecessary testing on admission in autologous stem cell transplant (SCT) patients." Journal of Clinical Oncology 30, no. 34_suppl (December 1, 2012): 185. http://dx.doi.org/10.1200/jco.2012.30.34_suppl.185.
Full textAbstract:
185 Background: Health care institutions are identifying strategies to reduce unnecessary testing, employ better utilization of resources, and decrease risk. At Dana-Farber Cancer Institute (DFCI), patients admitted for autologous SCT have standard testing, including CXR, completed within 42 days of hospital admission. Despite previous work-up, routine CXR is often ordered on admission. We questioned if this repeat CXR was clinically necessary. A retrospective review from 2010 showed that 69 of 130 (53%) asymptomatic SCT patients had CXR obtained on the day of admission. Two patients had findings of possible atelectasis vs. infiltrate on admission CXR. No further work up or antibiotics were initiated. After count recovery, one of the two patients had a chest CT for evaluation of fevers, showing only atelectasis. Based on these results, we aimed to reduce admission CXR without clinical indication to less than 5% by July 1, 2012. Methods: A multidisciplinary group was formed to map existing processes leading to admission CXR. Areas where previous standard testing were not readily available and areas of redundancy were identified. Changes to the EMR allowing easier access to pre-transplant results were made and a written and oral education program for PAs and nocturnists was created. Study Population: All elective patients admitted to the bone marrow transplant PA service (BMT-PA) for autologous SCT for multiple myeloma or lymphoma between 11/1/11-5/30/12. Results: The intervention (changing the EMR and establishing an education program) resulted in a reduction of admission CXR in asymptomatic patients from 53.3% to 5.5% (target 5.0%). During the study period, 144 patients were admitted to the BMT-PA service. Of those, 8 had CXR without indication. All CXR were ordered by Nocturnists, two prior to the intervention and six in the last four weeks of the observation period. Conclusions: The reduction of unnecessary CXR in asymptomatic SCT patients has had a considerable reduction in overall costs, nearly $58,000 to date, as well as reduced delays in initiating chemotherapy, radiation exposure, overall resource utilization, and patient inconvenience. Through this simple intervention, this reduction was easily obtained.
8
AL-Mutairi, Abdullah, and Muna Saeid. "Factors Affecting Students’ Choice for MBA Program in Kuwait Universities." International Journal of Business and Management 11, no. 3 (February 26, 2016): 119. http://dx.doi.org/10.5539/ijbm.v11n3p119.
Full textAbstract:
The attempt is made in this study to identify students’ motives and reasons behind enrolling in a MBA program offered by universities operating in Kuwait. It also explores criterion used to select the program. To achieve these objectives, data were collected through a well-designed and structured questionnaire and pre-testing was carried out to examine the efficiency of the instrument. The study showed that the main reasons behind selecting the MBA program by students are to satisfy their personal concerns and improve their knowledge and skills. Moreover, the students used program alumni and campus visit as main sources of information followed by friends’ suggestions and university websites. When evaluating the MBA programs, the students cited overseas accreditation as the most used criteria followed by faculty reputation, institution reputation and admission requirements.
9
Chabasse, Catherine, and Stephanie Kader. "Putting interpreting admissions exams to the test." Interpreting. International Journal of Research and Practice in Interpreting 16, no. 1 (March 10, 2014): 19–33. http://dx.doi.org/10.1075/intp.16.1.02cha.
Full textAbstract:
With increasing numbers of students wishing to become conference interpreters, but limited capacities in most university degree programs, accurate admission testing is an important means of predicting an applicant’s chances of completing the program successfully. This article focuses on three aptitude tests for simultaneous interpretation: Pöchhacker’s SynCloze test; Chabasse’s cognitive shadowing test; and Timarová’s personalized cloze test. The test battery was administered at the start of the 2009/2010 academic year to students beginning the two-year Master’s program in conference interpreting (MA KD) at Germersheim. Correlations between test performance and subsequent exam grades at the end of the second semester were examined for all three tests. Given the large number of applicants each year, practical feasibility of the tests was taken into consideration with a view to scheduling the format and content of the entrance exam for the 2012/2013 academic year. In this perspective, cognitive shadowing was identified as the most useful test under the existing time constraints.
10
Cameron, Andrea J., and Linda D. MacKeigan. "Development and Pilot Testing of a Multiple Mini-Interview for Admission to a Pharmacy Degree Program." American Journal of Pharmaceutical Education 76, no. 1 (February 10, 2012): 10. http://dx.doi.org/10.5688/ajpe76110.
Full text
11
Scott, Jeffrey A., Scott Milligan, Winston Wong, Daniel Winn, Joseph Cooper, Neil Schneider, Sheamus Parkes, and Bruce A. Feinberg. "Validation of observed savings from an oncology clinical pathways program." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): 6553. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.6553.
Full textAbstract:
6553 Background: Oncology clinical pathways have been suggested as a way to decrease cancer treatment variation and costs. CareFirst BlueCross BlueShield (CFBCBS) partnered with Cardinal Health Specialty Solutions to launch the first cancer clinical pathway in the US in Aug 2008. Savings from that program were reported by Scott et al, ASCO 2010. The purpose of this study was to obtain third-party validation of the observed savings of this pathways program. Methods: We used CFBCBS claims data from Jan 2007 to Dec 2010 to identify patients (pts) with breast, colon, or lung cancer who were treated by physicians participating in the pathways program. We used Truven Health’s MarketScan database to retrospectively identify a control group treated by non-institutional physicians in a similar geographic region outside the CFBCBS network. We further balanced the groups using propensity score weighting to align primary diagnosis and demographics. The primary outcome was the sum of allowed cancer costs for 270 days after a patient’s first chemotherapy treatment. A secondary outcome was the probability of an inpatient (inpt) admission over the same time period. Many generalized linear models were fit for sensitivity testing. Boosted decision tree models were also used to fully capture all nonlinearities and interactions. Both types of models use the propensity score weights. All savings estimates were based on comparing trends between cohorts. Results: A total of 2424 CFBCBS pts were included in the analysis. The aligned control group consisted of 1490 pts. The treatment coefficient from the linear model for the primary outcome was -0.16 with a z-value of -3, which translates to a savings estimate of 15% for the program. The treatment coefficient from the logistic model for the secondary outcome of inpt admission reduction was -0.29 with a z-value of -2.5, which translated to a 7% reduction (from 50% to 43%) in hospital admissions. The boosted decision tree models confirmed results of a more moderate magnitude. Conclusions: We conclude that the CFBCBS pathways program saved upwards of 15% on cancer-related claims costs with a 7% reduction in the probability of an inpt admission. These findings are consistent with those previously presented and peer reviewed.
12
Rasmusson, Jenna, Nancy Wengenack, and Priya Sampathkumar. "Implementing Admission Screening for Candida auris." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s281. http://dx.doi.org/10.1017/ice.2020.852.
Full textAbstract:
Background:Candida auris is a globally emerging, multidrug-resistant fungal pathogen that causes serious, difficult-to-treat infections in hospitalized patients. C. auris cases in the United States have been linked to receipt of healthcare overseas. Outbreaks have also occurred in New York City, New Jersey, Chicago, and most recently in California. We provide care to patients from all 50 states and 138 countries; therefore, we are at risk for encountering C. auris in our facility. Setting: An academic, tertiary-care center with 1,297 licensed beds and >62,000 admissions each year. Methods: Infection prevention and control (IPAC) initiated a C. auris screening program in August 2019 in partnership with the State Health Department. A case-finding tool was created to identify adult patients admitted in the previous 24 hours from countries and areas of the United States (Chicago, New Jersey, and New York metropolitan areas) with known C. auris transmission based on the zip code of their primary address. IPAC sends an electronic communication via the electronic medical record (EMR) alerting the patient care team that the patient meets criteria for screening along with information on C. auris and links to a tool kit with additional resources to help answer questions. After obtaining verbal consent, the patient’s primary nurse collects a composite axilla–groin skin swab using a nylon-flocked swab (BD ESwab collection and transport system; Becton Dickinson, Sparks, MD). The sample is sent to the State Health Department laboratory for testing by polymerase chain reaction (PCR). Results are communicated back to IPAC and then scanned into the patient’s EMR. Results: From August 2019 to November 2019, 157 patients were identified for C. auris screening using the case-finding tool. Testing was performed on 95 patients; all tests were negative. The primary reasons for testing not to be performed on eligible patients were inability to obtain verbal consent and patient dismissal before sample could be obtained. The need for a special swab that is not routinely stocked on patient care units has been a limitation to timely specimen collection. Conclusions: The EMR can be leveraged for early identification and screening of patients at risk of C. auris colonization. Case finding tools can be effectively replicated and modified to respond to emerging infections and changing surveillance guidelines.Funding: NoneDisclosures: None
13
Alghalayini, Kamal Waheeb. "Effect of diuretic infusion clinic in preventing hospitalization for patients with decompensating heart failure." SAGE Open Medicine 8 (January 2020): 205031212094009. http://dx.doi.org/10.1177/2050312120940094.
Full textAbstract:
Introduction: It is proposed that access to administering intravenous furosemide outside the hospital can contribute to lowering hospital admissions for heart failure. This study aims to evaluate the effect of outpatient furosemide infusion protocol in preventing hospitalization for patients with decompensating heart failure. This constitutes designing a viable clinical pathway in hospitals using a multidisciplinary heart failure program. Methods: A prospective interventional study testing the effect of diuretic infusion clinic in preventing hospitalization for patients with decompensating heart failure was conducted on 150 decompensating heart failure patients requiring hospital admission. Only 105 patients met the criteria and subsequently enrolled in the study. Each patient was administered intravenous furosemide infusion one or more times according to the protocol and depending on their symptoms of decompensation. Patients were referred for admission at any point once there is no improvement of their medical condition, or referred to heart failure clinic when clinical picture improved as observed by the treating team. Results: In total, 14 of 105 patients who received intravenous furosemide infusion did not respond to diuretic infusion protocol and required hospital admission while 91 patients responded to same protocol and did not require admission, P value was statistically significant in three laboratory test measures of potassium (<0.001), urea (0.004), and creatinine (0.008). Heart failure with reduced ejection fraction was observed in 70 (76.9%) responders with a mean ejection fraction of 23% and in 9 (64.3%) non-responders with mean ejection fraction of 19.9%. Conclusion: Outpatient intravenous furosemide infusion protocol is effective in preventing hospitalization for decompensating heart failure and a viable clinical pathway for heart failure programs.
14
Woodard, Peggy G., Annie L. Lawrence, and David E. Suddick. "A Revalidation of the Use of the American College Testing Proficiency Examination Program for Admission to the Masters Degree of Nursing Program." Educational and Psychological Measurement 50, no. 3 (September 1990): 643–45. http://dx.doi.org/10.1177/0013164490503021.
Full text
15
Shealy, Stephanie C., Christine Alexander, Tina Grof Hardison, Joseph Magagnoli, Julie Ann Justo, Caroline Derrick, Joseph Kohn, et al. "Pharmacist-Driven Culture and Sexually Transmitted Infection Testing Follow-Up Program in the Emergency Department." Pharmacy 8, no. 2 (April 23, 2020): 72. http://dx.doi.org/10.3390/pharmacy8020072.
Full textAbstract:
Expanding pharmacist-driven antimicrobial stewardship efforts in the emergency department (ED) can improve antibiotic management for both admitted and discharged patients. We piloted a pharmacist-driven culture and rapid diagnostic technology (RDT) follow-up program in patients discharged from the ED. This was a single-center, pre- and post-implementation, cohort study examining the impact of a pharmacist-driven culture/RDT follow-up program in the ED. Adult patients discharged from the ED with subsequent positive cultures and/or RDT during the pre- (21 August 2018–18 November 2018) and post-implementation (19 November 2018–15 February 2019) periods were screened for inclusion. The primary endpoints were time from ED discharge to culture/RDT review and completion of follow-up. Secondary endpoints included antimicrobial agent prescribed during outpatient follow-up, repeat ED encounters within 30 days, and hospital admissions within 30 days. Baseline characteristics were analyzed using descriptive statistics. Time-to-event data were analyzed using the Wilcoxon signed-rank test. One-hundred-and-twenty-seven patients were included, 64 in the pre-implementation group and 63 in the post-implementation group. There was a 36.3% reduction in the meantime to culture/RDT data review in the post-implementation group (75.2 h vs. 47.9 h, p < 0.001). There was a significant reduction in fluoroquinolone prescribing in the post-implementation group (18.1% vs. 5.4%, p = 0.036). The proportion of patients who had a repeat ED encounter or hospital admission within 30 days was not significantly different between the pre- and post-implementation groups (15.6 vs. 19.1%, p = 0.78 and 9.4% vs. 7.9%, p = 1.0, respectively). Introduction of a pharmacist culture and RDT follow-up program in the ED reduced time to data review, time to outpatient intervention and outpatient follow-up of fluoroquinolone prescribing.
16
Cecins, Nola, Holly Landers, and Sue Jenkins. "Community-based pulmonary rehabilitation in a non-healthcare facility is feasible and effective." Chronic Respiratory Disease 14, no. 1 (July 8, 2016): 3–10. http://dx.doi.org/10.1177/1479972316654287.
Full textAbstract:
Pulmonary rehabilitation programs (PRPs) are most commonly provided in hospital settings which present barriers to attendance such as long distances or travel times. Community-based settings have been used in an attempt to alleviate the travel burden. This study evaluated the feasibility and outcomes of a network of community-based PRPs provided in non-healthcare facilities (CPRPs). The CPRPs were established in five venues and comprised two supervised group sessions each week for 8 weeks. Participant inclusion criteria and guidelines for exercise testing and training were developed to reduce the risk of adverse events. Outcome measures included 6-min walk distance (6MWD) and health-related quality of life (chronic respiratory questionnaire (CRQ)). Respiratory-related hospital admission data were collected in the 12 months prior to and following the program. Two hundred and fifty-one participants (79% with chronic obstructive pulmonary disease: mean ± SD FEV1 49 ± 21%predicted) entered a CPRP of which 166 (66%) completed. Improvements were demonstrated in 6MWD (mean difference (95% CI) 44 m (37–52)) and total CRQ score (0.5 points per item (0.4–0.7)). Fewer participants had a respiratory-related hospital admission following the program (12% vs. 37%, p < 0.0001). Pulmonary rehabilitation is safe, feasible and effective when conducted in community-based non-healthcare facilities.
17
Loevinsohn, Gideon, Justin Hardick, Thomas Mehoke, Pamela Sinywimaanzi, Mutinta Hamahuwa, Katherine Z. J. Fenstermacher, Kathryn Shaw-Saliba, et al. "Nosocomial Respiratory Infections in a Rural Zambian Hospital." American Journal of Tropical Medicine and Hygiene 105, no. 3 (September 15, 2021): 818–21. http://dx.doi.org/10.4269/ajtmh.20-1470.
Full textAbstract:
ABSTRACT. The burden of nosocomial respiratory infections in rural southern Africa is poorly understood. We established a surveillance program at a rural Zambian hospital to detect influenza-like illness (ILI) and respiratory infections among hospitalized patients and a cohort of healthcare workers (HCWs). Nasopharyngeal specimens from symptomatic patients and HCWs underwent broadly multiplexed molecular testing to detect viruses and atypical bacteria. During 1 year of surveillance, 15 patients (1.7% of admissions) developed ILI more than 48 hours after admission. Among 44 HCWs, 19 (43%) experienced at least one ILI episode, with a total of 31 ILI episodes detected. Respiratory viruses were detected in 45% of patient and 55% of HCW specimens. The cumulative incidence of influenza infection among HCWs over 1 year was 9%. Overall, respiratory viruses were commonly found among patients and HCWs in a rural Zambian hospital with limited infection control infrastructure.
18
Wallingford, Kristina, and Lori Baas Rubarth. "Development and Evaluation of a Radiation Safety Program in the NICU." Neonatal Network 36, no. 5 (2017): 306–12. http://dx.doi.org/10.1891/0730-0832.36.5.306.
Full textAbstract:
AbstractPurpose: To develop and evaluate a radiation safety program used to educate NICU staff regarding safety procedures to minimize the effects of radiation on the newborn.Background: Advancements in medical care have resulted in infants born at lower gestational ages and higher acuity. With increased acuity comes an increase in diagnostic testing, including radiologic imaging. Although x-rays are necessary, they do not come without risk, including the future development of cancers.Methods: The number of x-rays completed in the NICU over a one-year period, was evaluated prior to the radiation safety program, directly after implementation, and five years postintervention.Results: Prior to the radiation safety program, the mean number of x-rays was 4.2 per patient per NICU admission. Immediately after implementation, the mean decreased to 3.8 per patient, and five years postintervention, the mean significantly decreased to 1.9 x-rays per patient per NICU stay.
19
Banerji, Anna, Vladimir Panzov, Michael Young, Bonita E. Lee, Muhammad Mamdani, B. Louise Giles, Marguerite Dennis, et al. "The Real-Life Effectiveness of Palivizumab for Reducing Hospital Admissions for Respiratory Syncytial Virus in Infants Residing in Nunavut." Canadian Respiratory Journal 21, no. 3 (2014): 185–89. http://dx.doi.org/10.1155/2014/941367.
Full textAbstract:
BACKGROUND/OBJECTIVE: Nunavut has the highest hospitalization rates for respiratory syncytial virus (RSV) worldwide, with rates of 166 per 1000 live births per year <1 year of age. Palivizumab was implemented in Nunavut primarily for premature infants, or those with hemodynamically significant cardiac or chronic lung disease; however, the effectiveness of the program is unknown. The objective of the present multisite, hospital-based surveillance study was to estimate the effectiveness of palivizumab in infants <6 months of age in Nunavut for the 2009 and 2010 RSV seasons.METHODS: Infants identified as palivizumab candidates who were <6 months of age were compared with all admissions for lower respiratory tract infection through multisite, hospital-based surveillance documenting the adequacy of palivizumab prophylaxis, admission for lower respiratory tract infection and the results of RSV testing. The OR for RSV admission in unprophylaxed infants was compared with those who were prophylaxed, and the effectiveness of palivizumab was estimated.RESULTS: Within the study cohort (n=101) during the two RSV seasons, five of the 10 eligible infants who did not receive adequate prophylaxis were admitted with RSV while two of the 91 infants <6 months of age eligible for palivizumab who were adequately prophylaxed were hospitalized with RSV (OR 22.3 [95% CI 3.8 to 130]; P=0.0005). The estimated effectiveness of palivizumab for the cohort was as high as 96%. Eight eligible infants were missed by the program and did not receive prophylaxis.CONCLUSION: Palivizumab was highly effective in reducing hospitalizations due to RSV infection in Nunavut. Further efforts need to be made to ensure that all eligible infants are identified.
20
Linsenmeyer, Katherine, Stephen Brecher, Judith Strymish, William O’Brien, Alexandra Rochman, Kamal Itani, and Kalpana Gupta. "C. difficile Screening for Colonization among Surgical Ward Admissions Is Feasible and Useful." Open Forum Infectious Diseases 4, suppl_1 (2017): S404. http://dx.doi.org/10.1093/ofid/ofx163.1010.
Full textAbstract:
Abstract Background Identification of patients colonized with C. difficile (CDcol) upon admission and initiation of precautions has been shown to decrease hospital-acquired C. difficileinfection (HA-CDI) in a recent study. We implemented a quality improvement program screening new admissions to a surgical service and evaluated risk factors and outcomes associated with CDcol. Methods Prospective cohort of all patients admitted to the surgical wards including ICU over a 6 month period 10/16–4/17. Upon admission, a perirectal swab was sent for C diff PCR. Patients with positive screens were placed on contact precautions. CDcol patients were not treated. Testing for CDI was done as usual practice only in patients with diarrhea. Main outcome was prevalence of CDcol and relationship to HA-CDI. Results Of 708 surgical admissions, 585 (82.6%) patients were screened, 543 were eligible based on first admission; 19 (3.5%) were colonized. Recent surgical hospitalization (OR 13.2, 95% CI 3.4;52.1) and prior CDI (OR 19.5, 95% CI 2.9;127.7) were independent risk factors for CDcol. Antibiotic and PPI use were not associated. Of those with CDcol, 7 developed CDI (36.8%) compared with 5/524 (0.9%) screen negative patients (adj OR 60, 95% CI 12.6;286). CDcol combined with a prior h/o CDI allowed for detection of 8/12 (75%) cases of HA-CDI compared with 3/12 (25%) if only prior history was available. HA-CDI rates on surgical wards after one month post-implementation were 9.3/10,000 bed days of care compared with 12.2 in 2016 and 12.8 in 2015. No delays in bed flow were identified. Conclusion Admission CDcol prevalence was low in our surgical VA population but was strongly associated with development of HA-CDI. Prior CDI was the strongest risk factor for CDcol and HA-CDI. Knowledge of prior CDI and CDcol status identified 75% of patients who developed CDI, 3 times more than knowledge of prior CDI alone. In certain settings, CDcol screening could improve detection and early isolation of potential CDiff spreaders. Implementation required significant support from administration, nursing and the laboratory, and was successful based on screening percentage without impact on bed flow. Impact on facility CDI rates remains to be fully demonstrated. Disclosures All authors: No reported disclosures.
21
Puspita, Desi. "Perangkat Lunak Bantu Penerimaan Siswa Baru Pada SD Methodist-5 Pagar Alam." Jurnal Ilmiah Betrik 8, no. 03 (November 14, 2017): 123–36. http://dx.doi.org/10.36050/betrik.v8i03.73.
Full textAbstract:
Software is a computer program associated with software documentation such as need documentation, design model, and user manual or a computer program without associated documentation. Software built by engineering is not manufactured by manufacture or manufacturer. The purpose of the development of software aids is to assist data collection in the process of admission of new students in SD Methodist-5 Pagar Alam. The process of data collection applied in SD Methodist-5 Pagar Alam is by using conventional method, that is by recording data process of new student acceptance which still using ledger, so that in process of data searching and report making can take a long time. Software development model used in this research is waterfall model that includes: System Engineering, Requirement analysis, Design, Coding, Testing and Maintenance.
22
Steffens, Andrea, Hannah Friedlander, Kathryn Como-Sabetti, Dave Boxrud, Sarah Bistodeau, Anna Strain, Carrie Reed, Ruth Lynfield, and Ashley Fowlkes. "Comparison of Respiratory Pathogen Detections from Routine Hospital Testing and Expanded Systematic Testing from the Minnesota Severe Acute Respiratory Illness Surveillance Program, 2015–2016." Open Forum Infectious Diseases 4, suppl_1 (2017): S16—S17. http://dx.doi.org/10.1093/ofid/ofx162.041.
Full textAbstract:
Abstract Background Hospital testing for respiratory pathogens is nonsystematic, leading to potential missed detection of clinically relevant pathogens. The Minnesota Severe Acute Respiratory Illness (SARI) surveillance program monitors hospitalizations due to acute respiratory illness and conducts systematic testing for several respiratory pathogens. We assessed viruses detected by the hospital and additional detections identified by expanded testing. Methods Residual upper respiratory specimens collected from patients hospitalized for suspected respiratory illness for routine diagnostic testing at three hospitals, including one children’s hospital, were submitted to the Minnesota Department of Health (MDH). Specimens were tested for 18 respiratory viruses by RT-PCR. Clinical and hospital test data were collected through medical record review. Results From September 2015 to August 2016, 2,351 hospitalized SARI patients were reported, with the following age distribution: 57% <5 years, 13% 5–17 years, 30% ≥18 years. Among all SARI patients, 97% (2,273) had hospital-based, clinician-directed testing for viral pathogens. Viruses were detected among 47% (1,077) of tested patients, among which testing methods included PCR (85%), rapid antigen (13%), and culture (2%); 74% were tested on the day of admission. Most common viruses detected by clinical testing included respiratory syncytial virus (41%), rhinovirus/enterovirus (31%), and influenza (15%) (Figure 1). Systematic RT–PCR testing at MDH identified 1,600 (68%) patients positive for ≥1 respiratory virus, identifying previously unknown detections among 35% (820) of SARI patients (Figure 2). Of 1,272 patients with no virus identified at the hospital, 46% (586) had a viral detection at MDH. Patients aged <18 years were significantly more likely to have an additional pathogen detected by MDH testing than those aged ≥18 years (P < 0.01), including rhinovirus/enterovirus, adenovirus, human metapneumovirus, and coronaviruses. Conclusion Systematic, expanded testing at MDH identified a higher proportion of respiratory pathogens among SARI patients compared with clinical laboratory testing. Additional testing for clinically relevant respiratory pathogens may inform medical decision-making. Disclosures All authors: No reported disclosures.
23
Maulana, Dicky, and Indah Suryani. "Perancangan Sistem Informasi Pendaftaran Peserta Didik Baru Berbasis Web pada SMK Kosgoro Kota Bogor." Indonesian Journal on Software Engineering (IJSE) 5, no. 1 (June 28, 2019): 9–18. http://dx.doi.org/10.31294/ijse.v5i1.5860.
Full textAbstract:
Abstract: New Student Admission is one process that exists in educational institutions such as schools that are useful for screening prospective students who are selected according to the criteria determined by the school to become students. In general, the process of admitting new students is done through the stages of registration, selection tests and announcements of new student admissions. So far, Kosgoro Vocational School has registered new student participants in a manual and not computerized way, causing time constraints and more costs for prospective students. In developing this application using the waterfall method includes the stages of determining software requirements, program design and testing of applications that have been made, In terms of making this website using Codeigniter and PHP so that the web display is more attractive and more efficient in accepting new students and providing convenience to prospective students to be able to register online and administrative staff can use it and see the latest developments in new student registration.
Keywords: New student registration, website, registration system
24
Oktaviyani, Enny Dwi, Dilla Ayu Dwipitaloka, Felicia Sylviana, and Licantik Licantik. "PERANCANGAN SISTEM INFORMASI PENERIMAAN PESERTA DIDIK BARU (PPDB) DAN REGISTRASI ONLINE BERBASIS WEBSITE PADA SMP NEGERI 6 PALANGKA RAYA." Jurnal Teknologi Informasi: Jurnal Keilmuan dan Aplikasi Bidang Teknik Informatika 14, no. 2 (August 10, 2020): 119–28. http://dx.doi.org/10.47111/jti.v14i2.1223.
Full textAbstract:
SMP Negeri 6 Palangka Raya has a new student admission activity every year. The Implementation of New Student Admissions for SMP Negeri 6 Palangka Raya is a routine activity to recruit prospective new students who come from elementary or MI. So far, it is known that at SMP Negeri 6 Palangka Raya, the system for accepting new students and re-registering new students is still done manually, namely prospective students come to school with the registration requirements in the form of a Certificate of Original National Graduation Result, a copy of the Family Card, and a photo
This makes the registration of new students and re-registration is ineffective and inefficient, because a lot of time, money and energy is wasted to register as new students and re-register at the school. Therefore we need a reliable, effective and efficient system that makes it easy for prospective new students who wish to register at the school and re-register when it is accepted to be accepted at the school, and also makes it easy for schools and committees in managing data of prospective new students quickly and efficiently and making credible reports, so that new student registration can be carried out properly
The software development method used is a waterfall, system analysis using data flow diagrams and entity relationship diagrams, program code using PHP and MySQL. Based on the results of testing using the blackbox, the new student admission information system can be used properly
25
Montoya, Michael, and Olga DeTorres. "Antimicrobial Selection and Its Impact on the Incidence of Clostridium difficile–Associated Diarrhea." Journal of Pharmacy Practice 26, no. 5 (August 12, 2013): 483–87. http://dx.doi.org/10.1177/0897190013499524.
Full textAbstract:
The study objective was to determine which antimicrobials place patients at a higher risk for Clostridium difficile–associated diarrhea (CDAD) and which interventions can reduce their risk. All patients with diarrhea and a positive toxin assay for Clostridium difficile for 3 months were included in the study. Patients were broken down into either community-acquired infection or health care–associated infection based on symptom onset, antibiotic usage prior to admission, and where the patient was admitted from. Physicians were educated on antimicrobials that place patients at higher risk for CDAD and alternative agents to use. Physician education consisted of in-service presentations, posters, Medical Grand Rounds, and an article in the physician newsletter highlighting the initial results of this study and alternative antimicrobial regimens. After implementation of educational programs, a repeat sample of patients was reviewed to determine effectiveness of the physician education. Cases of CDAD increased secondary to testing changes at our facility. Implicated antimicrobial usage did decrease after educational program implementation.
26
Manieri, Ellen, Michelle De Lima, and Nairita Ghosal. "Testing for success: A logistic regression analysis to determine which pre-admission exam best predicts success in an associate degree in nursing program." Teaching and Learning in Nursing 10, no. 1 (January 2015): 25–29. http://dx.doi.org/10.1016/j.teln.2014.08.001.
Full text
27
Gardiner, Fergus William. "Medical stewardship: Pathology evidence based ordering to reduce inappropriate test ordering in a teaching hospital." Journal of Hospital Administration 5, no. 1 (November 24, 2015): 73. http://dx.doi.org/10.5430/jha.v5n1p73.
Full textAbstract:
Objective: This study was designed as an educational program aimed at promoting evidence-based pathology ordering with the aim of reducing inappropriate test ordering.Methods: Researchers benchmarked the hospital’s pathology tests ordered in 2013-2014 before conducting a multifaceted education program in 2014-2015. The intervention consisted of main priorities including pathology test auditing, in-services and lectures, development and implementation of investigation pathways, and policy and procedure compliance. The main outcome measures was a reduction in commonly inappropriate ordered pathology testing leading to a reduction in the average test per hospital admission, and a reduction in specimen collection errors.Results: Through this educational method the researchers achieved a reduction in the average test per admission in 2014-2015 (M = 12.98) from 2013-2014 (M = 13.83). A two sample t-test indicated that this difference was significant, t(3.3006) = 0.0071, p = .01. The intervention included a focus on specimen collection errors and achieved a reduction in specimen error rates (M = 2,695) from the previous year (M = 3,000). A one sample t-test indicated that this difference was significant, t(3.0804) = 0.0105, p = .05. This intervention decreased commonly inappropriate pathology requests of Full Blood Count (FBC, -4.21%), Liver Function Tests (LFTs, -8.36%), Vitamin B12 (B12, -6.45%) and Coagulation profile (-21.22%). Commonly inappropriate pathology tests decreased (M = 7,120.33) from (M = 7,609.67). A two sample t-test indicated that this difference was significant, t(3.7730) = 0.0031, p = .005.Conclusions: Results confirmed that a multi-faceted education program can reduce inappropriate pathology test ordering, commonly over-ordered pathology test ordering, and pathology specimen error rates while maintaining positive patientoutcomes.
28
Harris, Anthony D., Lucia Nemoy, Judith A. Johnson, Amy Martin-Carnahan, David L. Smith, Hal Standiford, and Eli N. Perencevich. "Co-Carriage Rates of Vancomycin-ResistantEnterococcusand Extended-Spectrum Beta-Lactamase-Producing Bacteria Among a Cohort of Intensive Care Unit Patients: Implications for an Active Surveillance Program." Infection Control & Hospital Epidemiology 25, no. 2 (February 2004): 105–8. http://dx.doi.org/10.1086/502358.
Full textAbstract:
AbstractObjective:To assess the co-colonization rates of extended-spectrum beta-lactamase (ESBL)-producing bacteria and vancomycin-resistantEnterococcus(VRE) obtained on active surveillance cultures.Design:Prospective cohort study.Setting:Medical and surgical intensive care units (ICUs) of a tertiary-care hospital.Patients:Patients admitted between September 2001 and November 2002 to the medical and surgical ICUs at the University of Maryland Medical System had active surveillance perirectal cultures performed. Samples were concurrently processed for VRE and ESBL-producing bacteria.Results:Of 1,362 patients who had active surveillance cultures on admission, 136 (10%) were colonized with VRE. Among these, 15 (positive predictive value, 11%) were co-colonized with ESBL. Among the 1,226 who were VRE negative, 1,209 were also ESBL negative (negative predictive value, 99%). Among the 1,362 who had active surveillance cultures on admission, 32 (2%) were colonized with ESBL. Among these, 15 (47%) were co-colonized with VRE. Of the 32 patients colonized with ESBL, 10 (31%) had positive clinical cultures for ESBL on the same hospital admission. For these 10 patients, the surveillance cultures were positive an average of 2.7 days earlier than the clinical cultures.Conclusions:Patients who are colonized with VRE can also be co-colonized with other antibiotic-resistant bacteria such as ESBL-producing bacteria. Our study is the first to measure co-colonization rates of VRE and ESBL-producing bacteria. Isolating VRE-colonized patients would isolate 47% of the ESBL-colonized patients without the need for further testing. Hence, active surveillance for VRE should also theoretically diminish the amount of patient-to-patient transmission of ESBL-producing bacteria.
29
Ceballos, Roel. "Mortality Analysis of Early COVID-19 Cases in the Philippines Based on Observed Demographic and Clinical Characteristics." Recoletos Multidisciplinary Research Journal 9, no. 1 (June 3, 2021): 91–106. http://dx.doi.org/10.32871/rmrj2109.01.09.
Full textAbstract:
This study aims to determine the demographic, epidemiologic, and clinical characteristics of COVID-19 cases that are highly susceptible to COVID-19 infection, with longer hospitalization and at higher risk of mortality and to provide insights that may be useful to assess the vaccination priority program and allocate hospital resources. Methods that were used include descriptive statistics, nonparametric analysis, and survival analysis. Results of the study reveal that women are more susceptible to infection while men are at risk of longer hospitalization and higher mortality. Significant risk factors to COVID-19 mortality are older age, male sex, difficulty breathing, and comorbidities like hypertension and diabetes. Patients with these combined symptoms should be considered for admission to the COVID-19 facility for proper management and care. Also, there is a significant delay in the testing and diagnosis of those who died, implying that timeliness in the testing and diagnosis of patients is crucial in patient survival.
30
Umansky, Svetlana, Anne E. Holland, Kerryn L. Woolley, Frances M. Wise, and Peter C. Hunter. "Consistent evaluation of treatment outcomes across subacute and community settings: experience of the Graduated Discharge Program." Australian Health Review 35, no. 4 (2011): 486. http://dx.doi.org/10.1071/ah10956.
Full textAbstract:
Objective. Although mounting evidence suggests that early supporting discharge has benefits for both patients and the health service, such programs pose unique challenges for rigorous assessment of treatment outcomes. The aim of this study was to describe assessment of clinical outcomes in the Graduated Discharge Program (GDP) across hospital and community settings. Methods. The GDP involved substitution of community-based rehabilitation for the last week of inpatient care. A consensus group of hospital and community rehabilitation professionals chose the Timed Up and Go (TUAG) test as the primary clinical outcome that would be assessed across settings, with data stored in the community. We recorded the consistency of test performance across settings and readmission rates. Results. At hospital admission TUAG results were available for 82% of participants, compared to 94% at subacute discharge, 89% at end of GDP and 77% at end of community rehabilitation. Seat height during testing did not remain consistent across settings; however, significant improvements in TUAG were seen over time. There was no increase in readmission rate during the GDP. Conclusions. By involving members of the treating team in decisions about outcome assessment and data storage it was possible to reliably document clinical outcomes across multiple settings of care.
31
Dasenbrock, Hormuzdiyar H., Timothy R. Smith, and Shenandoah Robinson. "Preoperative laboratory testing before pediatric neurosurgery: an NSQIP-Pediatrics analysis." Journal of Neurosurgery: Pediatrics 24, no. 1 (July 2019): 92–103. http://dx.doi.org/10.3171/2018.12.peds18441.
Full textAbstract:
OBJECTIVESThe goal of this study was to evaluate clinical predictors of abnormal preoperative laboratory values in pediatric neurosurgical patients.METHODSData obtained in children who underwent a neurosurgical operation were extracted from the prospective National Surgical Quality Improvement Program–Pediatrics (NSQIP-P, 2012–2013) registry. Multivariable logistic regression evaluated predictors of preoperative laboratory values that might require further evaluation (white blood cell count < 2000/μl, hematocrit < 24%, platelet count < 100,000/μl, international normalized ratio > 1.4, or partial thromboplastin time > 45 seconds) or a preoperative transfusion (within 48 hours prior to surgery). Variables screened included patient demographics; American Society of Anesthesiologists (ASA) physical designation classification; comorbidities; recent steroid use, chemotherapy, or radiation therapy; and admission type. Predictive score validation was performed using the NSQIP-P 2014 data.RESULTSOf the 6556 patients aged greater than 2 years, 68.9% (n = 5089) underwent laboratory testing, but only 1.9% (n = 125) had a critical laboratory value. Predictors of a laboratory abnormality were ASA class III–V; diabetes mellitus; hematological, hypothrombotic, or oncological comorbidities; nutritional support; recent chemotherapy; systemic inflammatory response syndrome; and a nonelective hospital admission. These 9 variables were used to create a predictive score, with a single point assigned for each predictor. The prevalence of critical values in the validation population (NSQIP-P 2014) of patients greater than 2 years of age was 0.3% with a score of 0, 1.0% in those with a score of 1, 1.6% in those with a score of 2, and 6.2% in those with a score ≥ 3. Higher score was predictive of a critical value (OR 2.33, 95% CI 1.91–2.83, p < 0.001, C-statistic 0.76) and with the requirement of a perioperative transfusion (intraoperatively or within 72 hours postoperatively; OR 1.42, 95% CI 1.22–1.67, p < 0.001) in the validation population. Moreover, when the same score was applied to children aged 2 years or younger, a greater score was predictive of a critical value (OR 2.47, 95% CI 2.15–2.84, p < 0.001, C-statistic 0.76).CONCLUSIONSCritical laboratory values in pediatric neurosurgical patients are largely predicted by clinical characteristics, and abnormal preoperative laboratory results are rare in patients older than 2 years of age without comorbidities who are undergoing elective surgery. The NSQIP-P critical preoperative laboratory value scale is proposed to indicate patients with the highest odds of an abnormal value. The scale can assist with triaging preoperative testing based on the surgical risk, as determined by the treating surgeon and anesthesiologist.
32
Linfield, Rebecca Y., Shelley Campeau, Patil Injean, Aric Gregson, Fady Kaldas, Zachary Rubin, Tae Kim, et al. "Practical methods for effective vancomycin-resistant enterococci (VRE) surveillance: experience in a liver transplant surgical intensive care unit." Infection Control & Hospital Epidemiology 39, no. 10 (September 5, 2018): 1178–82. http://dx.doi.org/10.1017/ice.2018.178.
Full textAbstract:
AbstractObjectiveWe evaluated the utility of vancomycin-resistant Enterococcus (VRE) surveillance by varying 2 parameters: admission versus weekly surveillance and perirectal swabbing versus stool sampling.DesignProspective, patient-level surveillance program of incident VRE colonization.SettingLiver transplant surgical intensive care unit (SICU) of a tertiary-care referral medical center with a high prevalence of VRE.PatientsAll patients admitted to the SICU from June to August 2015.MethodsWe conducted a point-prevalence estimate followed by admission and weekly surveillance by perirectal swabbing and/or stool sampling. Incident colonization was defined as a negative screen followed by positive surveillance. VRE was detected by culture on Remel Spectra VRE chromogenic agar. Microbiologically-confirmed VRE bloodstream infections (BSIs) were tracked for 2 months. Statistical analyses were calculated using the McNemar test, the Fisher exact test, the t test, and the χ2 test.ResultsIn total, 91 patients underwent VRE surveillance testing. The point prevalence of VRE colonization was 60.9%; VRE prevalence on admission was 30.1%. Weekly surveillance identified an additional 7 of 28 patients (25.0%) with incident colonization. VRE BSIs were more common in VRE-colonized patients than in noncolonized patients (8 of 43 vs 2 of 48; P=.028). In a direct comparison, perirectal swabs were more sensitive than stool samples in detecting VRE (64 of 67 vs 56 of 67; P=.023). Compliance with perirectal swabbing was 89% (201 of 226) compared to 56% (127 of 226) for stool collection (P≤0.001).ConclusionsWe recommend weekly VRE surveillance over admission-only screening in high-burden units such as liver transplant SICUs. Perirectal swabs had greater collection compliance and sensitivity than stool samples, making them the preferred methodology. Further work may have implications for antimicrobial stewardship and infection control.
33
Naglie, Gary, Margaret McArthur, Andrew Simor, Monika Naus, Angela Cheung, and Allison McGeer. "Tuberculosis Surveillance Practices in Long-Term Care Institutions." Infection Control & Hospital Epidemiology 16, no. 3 (March 1995): 148–51. http://dx.doi.org/10.1017/s0195941700007281.
Full textAbstract:
AbstractObjecitves:To identify the tuberculosis (TB) skin-testing practices of long-term care facilities for the elderly in Toronto, Ontario.Design:A telephone survey using a 25-item questionnaire.Setting:Twenty-nine nursing homes (NHs) and 26 Homes for the Aged (HFAs) in metropolitan Toronto.Results:Thirty-one percent of facilities (17 of 55) had no formal tuberculin skin-testing program, including 52% of NHs (15 of 29) versus 8% of HFAs (2 of 26; P= 0.001). Ninety-two percent of HFAs (24 of 26) compared with 45% of NHs (13 of 29), obtained preadmission or admission skin-test status of residents (P= 0.0005). Annual testing was performed at 46% of HFAs (12 of 26) and 27% of NHs (8 of 29; P= 0.28). Of facilities that carried out any skin testing, 64% of HFAs (16 of 25) versus 32% of NHs (6 of 19) measured induration to establish test positivity (P=0.068). Fifty-two percent of HFAs (13 of 25), compared with 21% of NHs (4 of 19), recorded the actual size of induration in the patient record (P=0.085). Only 28% of HFAs (7 of 25) and 21% of NHs (4 of 19) correctly defined a positive tuberculin skin test.Conclusions:TB surveillance practices in long-term care institutions in Toronto are inadequate and often yield results that do not predict the risk of infection and cannot be used to investigate outbreaks. Tuberculin skin-testing practices were better at HFAs, which are subject to provincial legislation regarding TB surveillance, than at NHs, which are not subject to this legislation. Staff at HFAs and NHs require education regarding tuberculin skin-testing policies and procedures.
34
Marcelin, Jasmine R., Charlotte Brewer, Micah Beachy, Elizabeth Lyden, Tammy Winterboer, Lauren Hood, Paul D. Fey, and Trevor Van Schooneveld. "1095. The Value of Hardwiring Diagnostic Stewardship in the Electronic Health Record: Electronic Ordering Restrictions for PCR-Based Rapid Diagnostic Testing of Diarrheal Illnesses." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S328. http://dx.doi.org/10.1093/ofid/ofy210.930.
Full textAbstract:
Abstract Background In 2015, the microbiology laboratory introduced a multiplex PCR test (FilmArray™ Gastrointestinal Panel (GIP)), replacing traditional stool culture. The GIP is faster and more sensitive than traditional stool culture, detecting 22 common viral, bacterial, and parasitic pathogens; but is significantly more expensive. The antimicrobial stewardship program (ASP) developed guidelines on test use and interpretation, recommending inpatient use only once per admission and not after hospital day 5. C. difficile test results from the GIP were not reported at any time. Methods Inpatient GIP use was reviewed over one year and considered inappropriate if performed >3 days after admission or repeated. Noncompliance with ASP recommendations was common; no meaningful pathogens were detected upon review of all inappropriate GIP use. An inpatient GIP electronic order restriction was implemented in April 2017 eliminating the ability to order tests inappropriately. GIP testing outside the restriction could be approved by the microbiology lab director. We captured separate C. difficile testing rates as a counterbalance measure. We used Poisson regression models to compare the rate of GIP and C. difficile tests per month between Period 1 (July 2015–March 2017) and Period 2 (April 2017–March 2018) per 1,000 patient-days (PD). Results The restriction resulted in a 26% reduction in GIP ordering rates between the two periods (Table 1, Figure 1). Direct cost savings was approximately $63,000. Table 1 shows changes in C. difficile test ordering rates during Periods 1 and 2. When including GIP tests that were ordered but not completed, potential GIP testing was reduced by 46% for a savings of $131,000 (Figure 2). Only 42 test overrides were approved by the microbiology director since the intervention; of those only two were positive (Cryptosporidium and Norovirus). Conclusion Diagnostic stewardship of GIP using guidelines and electronic ordering restrictions can lead to meaningful improvements in test appropriateness and reduction in cost and waste, demonstrating the value of ASP interacting with the microbiology laboratory. Disclosures All authors: No reported disclosures.
35
Khan, Wasi Z., and Sarim Al Zubaidy. "Prediction of Student Performance in Academic and Military Learning Environment: Use of Multiple Linear Regression Predictive Model and Hypothesis Testing." International Journal of Higher Education 6, no. 4 (August 17, 2017): 152. http://dx.doi.org/10.5430/ijhe.v6n4p152.
Full textAbstract:
The variance in students’ academic performance in a civilian institute and in a military technological institute could be linked to the environment of the competition available to the students. The magnitude of talent, domain of skills and volume of efforts students put are identical in both type of institutes. The significant factor is the physical training, students undergo in a military college. It is important to couple the dominating factor which is academic perceivable effort under a different environment with each students learning capability. This paper determine whether there is a relationship between students’ performance and influencing factors like academic aptitude, military or physical training, and the time spent on training need analysis (TNA) modules. A sample of 242 first year- undergraduate students from four different engineering programs (Marine, System, Civil, and Aeronautical) at Military College was used to explore this relationship. The multiple regression model used for predicting the students’ performance is adequate for independent variables of aptitude test score, time spent in physical training, and time spent in TNA modules. The values of R2 indicate that at least one of the predictor variables contributes to information for the prediction of the students’ performance. The model makes it possible to predict moderately the possibility of attrition in engineering program. This study verifies that military academy has a very defined and directed core engineering course load and TNA course load which every student must take. Therefore, choice of specific discipline have less impact than at civilian institutions. The early detection of students at academic risk is a useful instrument that can help to design mentoring strategies right from the end of admission process.
36
Reukers, Daphne FM, Sierk D. Marbus, Hella Smit, Peter Schneeberger, Gé Donker, Wim van der Hoek, and Arianne B. van Gageldonk-Lafeber. "Media Reports as a Source for Monitoring Impact of Influenza on Hospital Care." JMIR Public Health and Surveillance 6, no. 1 (February 6, 2020): e14627. http://dx.doi.org/10.2196/14627.
Full textAbstract:
Background The Netherlands, like most European countries, has a robust influenza surveillance system in primary care. However, there is a lack of real-time nationally representative data on hospital admissions for complications of influenza. Anecdotal information about hospital capacity problems during influenza epidemics can, therefore, not be substantiated. Objective The aim of this study was to assess whether media reports could provide relevant information for estimating the impact of influenza on hospital capacity, in the absence of hospital surveillance data. Methods Dutch news articles on influenza in hospitals during the influenza season (week 40 of 2017 until week 20 of 2018) were searched in a Web-based media monitoring program (Coosto). Trends in the number of weekly articles were compared with trends in 5 different influenza surveillance systems. A content analysis was performed on a selection of news articles, and information on the hospital, department, problem, and preventive or response measures was collected. Results The trend in weekly news articles correlated significantly with the trends in all 5 surveillance systems, including severe acute respiratory infections (SARI) surveillance. However, the peak in all 5 surveillance systems preceded the peak in news articles. Content analysis showed hospitals (N=69) had major capacity problems (46/69, 67%), resulting in admission stops (9/46, 20%), postponement of nonurgent surgical procedures (29/46, 63%), or both (8/46, 17%). Only few hospitals reported the use of point-of-care testing (5/69, 7%) or a separate influenza ward (3/69, 4%) to accelerate clinical management, but most resorted to ad hoc crisis management (34/69, 49%). Conclusions Media reports showed that the 2017/2018 influenza epidemic caused serious problems in hospitals throughout the country. However, because of the time lag in media reporting, it is not a suitable alternative for near real-time SARI surveillance. A robust SARI surveillance program is important to inform decision making.
37
Leikhter, S. N., O. G. Malygina, and T. A. Bazhukova. "COMPETENCE-ORIENTED EXAM IN CLINICAL LABORATORY DIAGNOSTICS FOR STUDENTS STUDYING IN THE SPECIALTY “MEDICAL BIOCHEMISTRY”." Russian Clinical Laboratory Diagnostics 65, no. 3 (March 15, 2020): 197–200. http://dx.doi.org/10.18821/0869-2084-2020-65-3-197-200.
Full textAbstract:
In connection with the introduction of annexes and changes to the Federal State Educational Standard of Higher Education in the specialty 30.05.01 «Medical Biochemistry», a need arose to improve the assessment tool of general professional and professional competencies formation in the discipline - clinical laboratory diagnostics. A competence-oriented exam (COE) in the studied discipline is developed and implemented. Admission to the exam is the development of practical skills by students in the discipline modules, portfolio design and posting the results on the “Moodle” platform. COE includes two stages: testing to assess the level of theoretical knowledge deepening and solving a situational problem to assess the skills and abilities, interpret the results of laboratory tests and prepare a clinical and laboratory report. Situational tasks and checklists have been developed that make it possible to conduct an objective and comprehensive assessment of the competencies formed by students during the training process, which allows the graduate completed the program to solve professional problems.
38
Price, Kym Joanne, Brett Ashley Gordon, Stephen Richard Bird, and Amanda Clare Benson. "Evaluating Exercise Progression in an Australian Cardiac Rehabilitation Program: Should Cardiac Intervention, Age, or Physical Capacity Be Considered?" International Journal of Environmental Research and Public Health 18, no. 11 (May 28, 2021): 5826. http://dx.doi.org/10.3390/ijerph18115826.
Full textAbstract:
Progression of prescribed exercise is important to facilitate attainment of optimal physical capacity during cardiac rehabilitation. However, it is not clear how often exercise is progressed or to what extent. This study evaluated whether exercise progression during clinical cardiac rehabilitation was different between cardiovascular treatment, age, or initial physical capacity. The prescribed exercise of sixty patients who completed 12 sessions of outpatient cardiac rehabilitation at a major Australian metropolitan hospital was evaluated. The prescribed aerobic exercise dose was progressed using intensity rather than duration, while repetitions and weight lifted were utilised to progress resistance training dose. Cardiovascular treatment or age did not influence exercise progression, while initial physical capacity and strength did. Aerobic exercise intensity relative to initial physical capacity was progressed from the first session to the last session for those with high (from mean (95%CI) 44.6% (42.2–47.0) to 68.3% (63.5–73.1); p < 0.001) and moderate physical capacity at admission (from 53.0% (50.7–55.3) to 76.3% (71.2–81.4); p < 0.001), but not in those with low physical capacity (from 67.3% (63.7–70.9) to 85.0% (73.7–96.2); p = 0.336). The initial prescription for those with low physical capacity was proportionately higher than for those with high capacity (p < 0.001). Exercise testing should be recommended in guidelines to facilitate appropriate exercise prescription and progression.
39
Schoenmakers, Birgitte, and Johan Wens. "Efficiency, Usability, and Outcomes of Proctored Next-Level Exams for Proficiency Testing in Primary Care Education: Observational Study." JMIR Formative Research 5, no. 8 (August 16, 2021): e23834. http://dx.doi.org/10.2196/23834.
Full textAbstract:
Background The COVID-19 pandemic has affected education and assessment programs and has resulted in complex planning. Therefore, we organized the proficiency test for admission to the Family Medicine program as a proctored exam. To prevent fraud, we developed a web-based supervisor app for tracking and tracing candidates’ behaviors. Objective We aimed to assess the efficiency and usability of the proctored exam procedure and to analyze the procedure’s impact on exam scores. Methods The application operated on the following three levels to register events: the recording of actions, analyses of behavior, and live supervision. Each suspicious event was given a score. To assess efficiency, we logged the technical issues and the interventions. To test usability, we counted the number of suspicious students and behaviors. To analyze the impact that the supervisor app had on students’ exam outcomes, we compared the scores of the proctored group and those of the on-campus group. Candidates were free to register for off-campus participation or on-campus participation. Results Of the 593 candidates who subscribed to the exam, 472 (79.6%) used the supervisor app and 121 (20.4%) were on campus. The test results of both groups were comparable. We registered 15 technical issues that occurred off campus. Further, 2 candidates experienced a negative impact on their exams due to technical issues. The application detected 22 candidates with a suspicion rating of >1. Suspicion ratings mainly increased due to background noise. All events occurred without fraudulent intent. Conclusions This pilot observational study demonstrated that a supervisor app that records and registers behavior was able to detect suspicious events without having an impact on exams. Background noise was the most critical event. There was no fraud detected. A supervisor app that registers and records behavior to prevent fraud during exams was efficient and did not affect exam outcomes. In future research, a controlled study design should be used to compare the cost-benefit balance between the complex interventions of the supervisor app and candidates’ awareness of being monitored via a safe browser plug-in for exams.
40
Klinger, Amanda E., Ryan J. Kronen, Tomer Barak, Patricia Mophuthegi, Joseph Makhema, Rebecca Zash, and Roger Shapiro. "769. Mortality Among Inpatients After the Initiation of ‘Treat All’ With Dolutegravir in Botswana." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S429. http://dx.doi.org/10.1093/ofid/ofaa439.959.
Full textAbstract:
Abstract Background Botswana was the first African country to implement a ‘treat all’ dolutegravir (DTG)-based treatment program for all adults. We studied whether this transition made a short-term impact on inpatient mortality among people living with HIV (PLWHIV). Methods From Dec 2015-Nov 2017, data were collected prospectively on all patients admitted to the medical wards of a district hospital in Botswana. Tenofovir/emtricitabine/efavirenz (TDF/FTC/EFV) was the first-line recommended antiretroviral treatment (ART) regimen for all ART-naïve adults with CD4 < 350 until May 2016, when it was replaced by TDF/FTC/DTG without CD4 restriction (‘treat all’). Multivariable logistic regression was used to compare mortality by ART regimen. Results Of 1,969 patients admitted, 41.5% were PLWHIV and of these 62.9% were on ART prior to admission. Before ‘treat all’, 160 (58.0%) of 276 PLWHIV were on ART prior to admission, and post-implementation 354 (65.4%) of 541 PLWHIV were on ART prior to admission (p=0.01). Among 315 patients on EFV-based ART and 85 on DTG-based ART prior to admission, demographics were similar (Table 1), except for more recent ART initiation with DTG, and lower median CD4 cell count with DTG (256 vs. 339 cells/mm3). Tuberculosis (TB) and community acquired pneumonia were the leading causes of hospitalization for both regimens. Death occurred in 178 (21.8%) PLWHIV, including 29% not on ART and 19% on any ART (p=0.003). Overall, 38% who initiated ART < 3 months prior to admission died (23.7% DTG, 48.8% EFV), and 36% with CD4 cell count < 50 cells/mm3 died (42.9% DTG, 30.8% EFV). Fewer deaths occurred among those on EFV (18%) compared with those on DTG (27%). However, controlling for CD4 count and timing of ART start, the risk of mortality among those on DTG and EFV was similar (aRR 1.08, 95% CI 0.62, 1.87). TB was the leading cause of death (40.1% off ART, 31.8% on DTG, 22.2% on EFV). Table 1. Demographics, clinical characteristics, and outcomes of people living with HIV (PLWHIV) admitted to Scottish Livingstone Hospital, stratified by ART regimen prior to admission. Conclusion We found no improvement in inpatient mortality among PLWHIV during the shift to ‘treat all’ with DTG-based ART in Botswana. Decreasing high inpatient HIV mortality will require increased testing in the community to detect and treat PLWHIV prior to disease progression, and improved screening for opportunistic infections. Disclosures All Authors: No reported disclosures
41
Friedberg, Richard C., Bruce A. Jones, and Molly K. Walsh. "Type and Screen Completion for Scheduled Surgical Procedures." Archives of Pathology & Laboratory Medicine 127, no. 5 (May 1, 2003): 533–40. http://dx.doi.org/10.5858/2003-127-0533-tascfs.
Full textAbstract:
Abstract Context.—Market-driven changes in the timing of elective surgeries and admissions have introduced barriers to completing pretransfusion testing in a timely manner. Consequently, blood bank personnel may not have adequate time to identify appropriate blood products for scheduled surgeries. Incomplete pretransfusion testing can delay surgery and significantly compromise patient safety. Objectives.—To identify the incidence of avoidable problems associated with obtaining timely samples for adequate pretransfusion type and screen (T&S) testing, to identify the practices and characteristics associated with improved rates of pretransfusion testing completed prior to surgery, and to determine the likelihood of antibody identification problems that affect the availability of blood. Design.—Participants in the College of American Pathologists (CAP) Q-Probes laboratory quality improvement program were asked to collect data on when a T&S was collected in anticipation of elective scheduled surgery, when the T&S was completed, when the surgery started, and the results of those T&S tests. Participants also completed questionnaires describing their facilities, procedures, and practices. Setting and Participants.—One hundred eight public and private institutions participated in this Q-Probes Study, 97% of which were located in the United States. Main Outcome Measures.—Type and screen collection and completion relative to the start of surgery, and the results of those tests. Results.—Of the 8941 T&Ss, 64.6% were collected prior to the day of surgery. The median laboratory completed approximately 69% of their T&S testing for scheduled surgeries at least 1 day prior to the surgery. Of those T&S tests that were collected on the day of surgery, the median laboratory completed almost 23% after the start of surgery. For 10% of participants, more than 75% of all T&Ss collected on the same day as surgery were not complete until after the start of surgery. When red blood cell–directed antibodies were identified, 78.7% were considered clinically significant, and 95.2% were alloantibodies. Positive antibody screens were significantly associated with delayed surgery and special efforts needed to obtain blood. Of those institutions with a specific protocol in place to collect T&S samples prior to hospital admission, the median laboratory completed the T&S at least 1 day prior to surgery 74% of the time. When the institution coupled the T&S collection protocol with T&S collection earlier than 3 days prior to surgery, the median laboratory completed the T&S at least 1 day prior to surgery almost 87% of the time. Type and screen collection less than 3 days prior to surgery resulted in special efforts needed to obtain blood more than 1% of the time. Type and screen collected on the same day as surgery directly resulted in a surgery delay 0.8% of the time. Conclusions.—Patients are unnecessarily being placed at risk by inadequate mechanisms to ensure available blood for surgery. All T&Ss were collected for scheduled surgeries with adequate opportunity for a T&S to be completed in advance of the surgery. Specific protocols helped improve the performance in terms of completing the T&S prior to surgery, as did mechanisms that permitted T&S collections in advance of the admission. Type and screen collection time relative to surgery was significantly associated with the incidence of surgery delay due to unavailable blood; the less time between collection and surgery, the less likely blood was available.
42
Murillo, Cynthia, Rachel Marrs, Allison Bartlett, Emily Landon, and Jessica Ridgway. "Clostridioides difficile: Best Practice Alerts & Education to Reduce Unnecessary Testing." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s170. http://dx.doi.org/10.1017/ice.2020.697.
Full textAbstract:
Background: Unnecessary testing for Clostridioides difficile can lead facilities to overreport laboratory-identified (LabID) events. Because false-positive LabID tests could dilute infection control resources, we developed best practice alerts (BPAs) in the electronic health record, educational materials as well as a follow-up system to help reduce unnecessary testing and, therefore, reduce false-positive results. Methods: Three BPAs were initiated in late August, 2018. Alerts fired when clinicians tried to order repeat C. difficile testing after a positive result, testing within 24 hours of laxative administration and to order a multiplex PCR panel for GI pathogens >48 hours after admission. The GI multiplex PCR test consists of 21 targets, including C. difficile, but it allows for testing solid stool. All alerts gave suggestions for how to proceed (ie, not test for cure from previous positive, wait until laxatives wear off, or call for approval before GI panel) but could be bypassed by clinicians. Educational emails and signage were distributed to all house staff and clinicians in all clinical areas at the start of the program. For each bypassed BPA, infection control physicians contacted the ordering clinician by email or phone to explain why testing was not advised. Results: Between September 5, 2018, and April 23, 2019, 1,217 BPAs were issued: 634 in first half and 583 in the second half. Of these, 268 (22%) were bypassed by clinicians (Fig. 1). There was no significant decrease in bypassing BPAs. In the first half of the intervention, 22% of BPAs were bypassed (141 of 634). In the second 4 months, 22% of BPAS were still bypassed (127 of 583; P = .85). Of the 40 ordering services, 8 had no bypassed BPAs in the first half and 9 had no bypassed BPAs in the second half. Conclusions: Educating providers and following up after bypassed BPAs did not decrease the number of bypassed BPAs. Although fewer BPAs were issued in the second half of the intervention, more analysis is needed to understand whether this decrease is significant. In this study, 268 unnecessary C. difficile tests were ordered over 8 months.Funding: NoneDisclosures: None
43
Azahari, Azahari, Yulindawati Yulindawati, Dewi Rosita, and Syamsuddin Mallala. "Komparasi Data Mining Naive Bayes dan Neural Network memprediksi Masa Studi Mahasiswa S1." Jurnal Teknologi Informasi dan Ilmu Komputer 7, no. 3 (May 22, 2020): 443. http://dx.doi.org/10.25126/jtiik.2020732093.
Full textAbstract:
<p class="Abstrak">Prediksi kelulusan dibutuhkan oleh manajemen perguruan tinggi dalam menentukan kebijakan preventif terkait pencegahan dini kasus drop out. Lama masa studi setiap mahasiswa bisa disebabkan dengan berbagai faktor. Dengan menggunakan <em>data mining</em> algoritma <em>naive bayes</em> dan <em>neural network</em> dapat dilakukan prediksi kelulusan mahasiswa di STMIK Widya Cipta Dharma (WiCiDa) Samarinda . Atribut yang digunakan yaitu, umur saat masuk kuliah, klasifikasi kota asal Sekolah Menengah Atas, pekerjaan ayah, program studi, kelas, jumlah saudara, dan Indeks Prestasi Kumulatif (IPK). Sampel mahasiswa yang lulus dan <em>drop-out</em> pada tahun 2011 sampai 2019 dijadikan sebagai data <em>training</em> dan data <em>testing</em>. Sedangkan angkatan 2015–2018 digunakan sebagai data target yang akan diprediksi masa studinya. Sebanyak 3229 mahasiswa, 1769 sebagai data <em>training</em>, 321 sebagai data <em>testing</em>, dan 1139 sebagai data target. Semua data diambil dari data mahasiswa program strata 1, dan tidak mengikut sertakan data mahasiswa D3 dan alih jenjang/transfer. Dari data <em>testing </em>diperoleh tingkat akurasi hanya 57,63%. Hasil penelitian menunjukkan banyaknya kelemahan dari hasil prediksi <em>naive bayes</em> dikarenakan tingkat akurasi kevalidannya tergolong tidak terlalu tinggi. Sedangkan akurasi prediksi <em>neural network</em> adalah 72,58%, sehingga metode alternatif inilah yang lebih baik. Proses evaluasi dan analisis dilakukan untuk melihat dimana letak kesalahan dan kebenaran dalam hasil prediksi masa studi.</p><div><div><p><em><strong>Abstract</strong></em></p><p class="Abstract"><em>Graduation predictions are required by the higher education institution preventive policies related to the early prevention of drop-out cases. The duration of study, for each student can be caused by various factors. By using the data mining algorithm Naive bayes and neural network, the student graduation in STMIK Widya Cipta Dharma (WiCiDa) can be predicted. The attributes used are as follows: age at admission, classification of cities from high school, father’s occupation, study program, class, number of siblings, and grade point average (GPA). Samples of students who graduated and dropped out between year 2011 and 2019 were used as training data and testing data. While the year class of 2015to 2018 is used as the target data, which will be predicted during the study period. According to the data mining algorithm Naive bayes, there are 3229 students; 1769 as training data, 321 as testing data, and 1139 as target data. All data is taken from students enrolled in undergraduate program and does not include data on diploma students and transfer student. From the testing data, an accuracy rate only 57.63%. The other side, prediction accuracy of the neural network is 72.58%, so this alternative method is the best chosen. The research results show the many weaknesses of the results of prediction of Naive bayes because the level of accuracy of its validity is not high. The evaluation and analysis process are conducted to see where the errors and truths are in the results of the study period predictions.</em></p><p><em><strong><br /></strong></em></p></div></div>
44
Gmati, Giamal Edin, Nadine Mabsut, Zainab Matar, Mona Alshami, Husam Shahata, Areej Alkhesaifi, Mohamed Alharbi, et al. "Home Care Program for Managing Oncology Patients during COVID-19 Pandemic. a Tertiary Referral Center Experience." Blood 136, Supplement 1 (November 5, 2020): 21. http://dx.doi.org/10.1182/blood-2020-141782.
Full textAbstract:
Background COVID-19 pandemic disrupted heath care system all around the world and overwhelmed the capacity of hospital to manage regular patients including cancer patients. We implemented a new program to help managing oncology patients visited our Emergency Rooms (ER) and discharged home. Methods Our home care program designed to cover all aspects of patients care while they are at home by checking the ER list on daily basis and identify all oncology patients on this list. We developed an algorithm, to follow up our patients and the COVID-19 test status and to act accordingly (figure 1). The team consists of oncologist, oncology nurse specialists, patient educator and data management person. The primary oncologist of each patient is notified and consulted on the plan. The team follows the result and decide further steps of management accordingly. The intervention includes regular clinical assessment by calling the patient, arranging medication delivery, sending patients brochures explaining the necessary protective measured needs to be taken by patient and care givers and respond to patient and family queries and concerns. Results Between May 31 and July 31, 237 oncology patients seen in ED with different clinical presentations. One hundred forty two patients did not need admission and therefore discharged home. COVID-19 test was carried out according to the presenting symptoms and ARI score (test requested if score is 4 or more). Only 30 patients (21%) needed COVID-19 testing prior to discharge from ED and 6 patients tested positive. However, on our follow of those patients at home further 16 patients (11%) needed to be tested due to new developments of their symptoms and 3 patients tested positive. The main reasons for nor requesting COVID-19 for some patients either 1) recent testing in outpatient clinics or other health centers outside our institution Ministry of Health, 2) they are known to have covid-19 and still in active infection, 3) based on patient`s MRP decision not to swab patient for COVID -19. During our daily monitoring of patients at their homes, 12 patients (8%) were called back due to worsening of their symptoms and needed further assessment and management after discussion with their MRP. As per our infection control department guidelines, repeating COVID-19 testing for asymptomatic patients was not necessary and patient can be discharged from our records. This new model of care in our institution was presented to the COVID-19 pandemic command center and the program got the approval and recommended to be implemented in other departments as per patients need. Conclusion Oncology patients are vulnerable especially at this time of COVID-19 pandemic and our program is designed to reduce the risk of exposure and infection by looking after those patient while they are at home in addition to maintain the continuity of their cancer management. Figure Disclosures No relevant conflicts of interest to declare.
45
Palombaro, Kerstin M., Jill D. Black, Robin L. Dole, Sidney A. Jones, and Alexander R. Stewart. "Civic-Mindedness Sustains Empathy in a Cohort of Physical Therapy Students: A Pilot Cohort Study." Journal of Patient Experience 7, no. 2 (March 19, 2019): 185–92. http://dx.doi.org/10.1177/2374373519837246.
Full textAbstract:
Background: Empathy is critical to patient-centered care and thus is a valued trait in graduate health-care students. The relationship between empathy and civic-mindedness in health professions has not previously been explored. Objectives: (a) To determine whether significant differences occurred on the Jefferson Scale for Empathy–Health Professions Student Version (JSE-HPS) and Civic-Minded Professional scale (CMP) and its subscales across the curriculum, (b) to explore a potential relationship between civic-mindedness and empathy in a cohort of graduate physical therapy (PT) students at regular intervals, and (c) to explore the predictive ability of civic-mindedness on empathy scores. Methods: This study was a convenience sample of a cohort of 48 PT students who completed both the JSE-HPS and the CMP at 4 points of a service-learning intensive curriculum. Statistical analysis included descriptive statistics, a Friedman’s analysis of variance with Wilcoxon signed-ranks post hoc testing, and Spearman correlations with stepwise linear regressions. Results: Statistically significant differences were not found for the JSE-HPS. Civic-Minded Professional scores increased across the curriculum. The JSE-HPS, the CMP, and various CMP subscales were significantly correlated. The JSE-HPS pretest scores were predictive of the year 1 and 2 posttest JSE-HPS scores. Conclusion: This study’s findings indicate that service-learning and the resulting development of civic-mindedness supports empathy. Programs could use JSE-HPS pretests to identify individual graduate students need for empathy mentorship upon program entrance or as one admission criterion.
46
Muder, Robert R., Carole Brennen, and Kwan Ting Yu. "Choosing Appropriate Criteria for Tuberculin Positivity and Conversion in a Long-Term Care Facility." Infection Control & Hospital Epidemiology 14, no. 9 (September 1993): 523–26. http://dx.doi.org/10.1086/646797.
Full textAbstract:
AbstractObjectives:The Centers for Disease Control and Prevention has issued new criteria for conversion of the tuberculin skin test; in persons over 35 years of age, an increase in induration of at least 15 mm is considered indicative of new tuberculous infection. We reviewed our experience in a tuberculosis control program in a long-term care facility to assess the applicability of the new criteria to our patient population.Design:Retrospective review of seven years of tuberculosis control records and outbreak investigation.Setting:Long-term care Veterans Affairs hospital.Patients:All patients in the facility between 1985 and June 1992 who received routine admission and annual tuberculin skin testing or who were evaluated for possible exposure to active tuberculosis. A total of 2,342 skin tests were performed.Results:Mean increase in skin test diameter in patients with at least two prior negative tests and known exposure to active tuberculosis was 13.9 ± 4.7 mm. Frequency distribution histograms of skin test sizes of initial tuberculin testing in the entire population indicated 10 mm induration as a reasonable criterion for initial positivity.Conclusions:In our long-term care population, an increase in skin test induration of 10 mm may indicate new tuberculous infection. Criteria for skin test conversion derived from ambulatory populations in other geographic areas may not apply in all situations. Prevalence of infection with Mycobacterium tuberculosis and prevalence of skin test reactivity due to nontuberculous mycobacteria are likely to influence the predictive value of criteria for tuberculin conversion in a given population.
47
Djulbegovic, Mia, Kevin Chen, Soundari Sureshanand, and Sarwat Chaudhry. "Potential Overuse of Primary Thromboprophylaxis in Medical Inpatients at Low Risk of Venous Thromboembolism." Blood 134, Supplement_1 (November 13, 2019): 3385. http://dx.doi.org/10.1182/blood-2019-131827.
Full textAbstract:
Background: Venous thromboembolism (VTE) is a common cause of morbidity and mortality in the United States. Annually, up to 1 in 120 people develop VTE, approximating the incidence of stroke. Given that hospitalization and acute medical illness increase the risk of VTE, hospital-associated VTE represents a preventable cause of morbidity and mortality. Accordingly, accreditation and regulatory agencies endorse inpatient pharmacologic VTE prophylaxis (PPX) as a quality measure. In order to raise rates of PPX prescribing, many health systems have adopted a default approach to electronic ordering, in which clinicians must "opt-out" of PPX prescription. However, this strategy may cause medical overuse and avoidable harms, which has prompted the American Society of Hematology (ASH) to recommend a risk-adapted approach to PPX. One risk model endorsed by ASH is the IMPROVE-VTE risk assessment model, which can identify patients who are at low risk for VTE and therefore may not warrant pharmacologic PPX. We therefore sought to compare the actual practice of PPX prescribing to the guideline-recommended strategy according the IMPROVE-VTE model in a large, contemporary population of medical inpatients. Methods: In this observational study, we used electronic health record data to identify adult, medical inpatients hospitalized on general medical and subspecialty services at Yale-New Haven Hospital from 1/1/14-12/31/18. We excluded patients who were pregnant, admitted for VTE, taking full dose anticoagulation on admission, admitted for bleeding, or had a platelet count of < 50,000/µL. For each patient, we calculated the IMPROVE-VTE score using the previously validated model weights: 3 points for a prior history of VTE; 2 points for known thrombophilia, lower limb paralysis, or active cancer; 1 point for immobilization, admission to the intensive care unit, or age ≥ 60 years. For each component other than age, we used ICD-9 and ICD-10 codes that were billed either prior to or upon admission to determine the presence of these risk factors. In order to simulate the decision to initiate PPX on hospital admission, we calculated each patient's IMPROVE-VTE score at the time of admission. In accordance with the ASH guidelines, we used an IMPROVE-VTE score of <2 to differentiate patients at low-risk of hospital-associated VTE from those at high-risk. We used inpatient medication order history data to determine receipt of pharmacologic PPX. We used χ2 testing to compare the relative frequency of PPX prescribing on admission between patients at low-risk and high-risk for VTE. Results: We identified 135,288 medical inpatients during the study period, of whom 99,380 met inclusion criteria. The average age was 63.5 years-old (standard deviation 18 years); 51% of patients were female; 68% of patients were white. Of all the included patients, 81% received pharmacologic prophylaxis; of these patients, 78% received unfractionated heparin subcutaneously and 22% received low molecular weight heparin subcutaneously. Among all hospitalized patients, 78% had an IMPROVE-VTE score of <2 (32% had a score of 0 and 46% had a score of 1). Among these patients at low risk of hospital-associated VTE, 81% received pharmacologic PPX. Differences in prophylaxis rates between patients at low vs high risk of VTE were statistically significant (p<0.001). Conclusion: In this contemporary cohort of adult, medical inpatients, >80% of patients who were at low risk of hospital-associated VTE received pharmacologic PPX, representing a group in whom PPX may be unnecessary. Using a risk-adapted approach such as the IMPROVE-VTE risk assessment model, rather than default PPX ordering, may reduce medical overuse and avoidable harms. Disclosures Chaudhry: CVS State of CT Clinical Pharmacy Program: Other: Paid Reviewer for CVS State of CT Clinical Pharmacy Program.
48
Cooper, Christopher A., and H. Gibbs Knotts. "Do I Have to Take the GRE? Standardized Testing in MPA Admissions." PS: Political Science & Politics 52, no. 03 (February 26, 2019): 470–75. http://dx.doi.org/10.1017/s1049096519000027.
Full textAbstract:
ABSTRACTGraduate-program decision makers face a similar challenge: how to design an admissions process that screens out applicants who are unlikely to succeed but does not provide too high an entry barrier for students who can be successful. This study catalogs the use of standardized testing in Master of Public Administration admissions and finds that less than one third of programs require standardized tests for all applicants. Moreover, program prestige, program diversity, and program size do not affect the likelihood that a program requires the Graduate Record Examination. This study also reviews the various standards that universities use to provide test waivers and also discusses other common application materials. The results should be of interest to undergraduate academic advisers and graduate-program directors as well as scholars and practitioners of higher-education administration more generally.
49
Taylor, Zachary W. "Speaking in Tongues: Can International Graduate Students Read International Graduate Admissions Materials?" International Journal of Higher Education 6, no. 3 (May 25, 2017): 99. http://dx.doi.org/10.5430/ijhe.v6n3p99.
Full textAbstract:
A recent Educational Testing Services report (2016) found that international graduate students with a TOEFL score of 80—the minimum average TOEFL score for graduate admission in the United States—usually possess reading subscores of 20, equating to a 12th-grade reading comprehension level. However, one public flagship university’s international graduate student admissions instructions are written at a 17th-grade reading comprehension level, or, a 27-30 band on the reading section of the TOEFL. This study seeks to answer the question, “Do U.S. graduate programs compose admissions materials at unreadable levels compared to these programs’ minimum reading comprehension levels for international graduate student admission?” Findings reveal average public flagship international graduate student admissions materials are written above 15th-grade reading comprehension levels, with select flagships composing these materials at 19th grade reading levels. Implications for practitioners and policymakers, as well as areas of future research, are addressed.
50
GUIMARÃES, Maia Nogueira Crown, Tila FACINCANI, and Sigrid De Sousa dos SANTOS. "Hepatitis B status in hemodialysis patients." Arquivos de Gastroenterologia 54, no. 4 (July 13, 2017): 356–58. http://dx.doi.org/10.1590/s0004-2803.201700000-34.
Full textAbstract:
ABSTRACT BACKGROUND: Patients on chronic dialysis present a high prevalence of hepatitis B virus infection. Despite infection-control practices, surveillance of serological markers, and hepatitis B vaccination, there are still outbreaks of the disease in dialysis centers. OBJECTIVE: This study aims to assess the serologic and vaccination status for hepatitis B in hemodialysis patients. METHODS: This cross-sectional study assessed serologic markers and hepatitis B vaccination status of chronic kidney disease patients on regular dialysis program in São Carlos, SP, Brazil. Patients without information about hepatitis B status (anti-HBc, HBsAg and anti-HBs) were referred for testing. Individuals with uncertain or incomplete immunization status and without serological conversion (anti-HBs <10mIU/mL) were referred to vaccination, with adverse effects monitored. RESULTS: The study included 130 from a total of 181 dialysis patients. The majority were male (63.8%), mean age 53.9 years. All patients were already screened and negative for HBsAg, and 73.8% were vaccinated against hepatitis B (59.2% complete and 14.6% incomplete schedule), with a seroconversion rate of 75.3%. Only 11 (8.5%) patients had prior dosage of anti-HBc (negative). Among the 47 patients referred for anti-HBc testing, four were anti-HBc positive and one indeterminate. Of the total of patients referred to immunization, 34 have actually received HBV vaccine; among them five had mild adverse effects. CONCLUSION: Despite the benefit of dosing of anti-HBc and anti-HBs before admission to dialysis, economic constraints have reduced the screening to only HBsAg. Since occult HBV infection has already been demonstrated in hemodialysis patients, the measure of anti-HBc should be encouraged.