Journal of evaluation in clinical practice
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Observational Study
Procalcitonin utilization in the real world: An observational study of antibiotic prescribing practices.
This study aims to better understand and describe antibiotic prescribing practices and adherence to a procalcitonin (PCT)-guided algorithm in patients undergoing serum PCT testing in adult hospitalized patients. ⋯ Hospital-based providers are more likely to overrule the algorithm and either initiate or continue antibiotics when guidelines encourage discontinuing antibiotics. These findings have important implications for antimicrobial stewardship and patient care and suggest that hospital-based providers may benefit from targeted didactics regarding the interpretation of the serum PCT assay.
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Providing high-quality primary care in patient-centred medical homes (PCMHa) requires competencies that can only be provided by interprofessional (IP) education. The benefits of collaborative training have been documented for learners, but less is known about the perceptions of the clinical professionals who train the learners or the patients receiving IP primary care. This investigation compared stakeholder attitudes about IP education, training, and providing collaborative care prior to developing a new IP training programme. ⋯ This is the first reported data comparing perceptions about IP training and care across these three stakeholder groups. Results suggest the need to clarify scope of practice, define professional roles, and bridge gaps between teaching PCMH principles and subsequently providing high-quality health care. Results inform faculty development needs in learning ways to train learners across professions and outline ways to structure interactions with patients.
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In the context of the gradual development of artificial intelligence in health care, the clinical decision support systems (CDSS) play an increasing crucial role in improving the quality of the therapeutic and diagnostic efficiency in health care. The fuzzy logic (FL) provides an effective means for dealing with uncertainties in the health decision-making process; therefore, FL-based CDSS becomes a very powerful tool for data and knowledge management, being able to think like an expert clinician. This work proposes an FL-based CDSS for the evaluation of renal function in posttransplant patients. ⋯ We propose that the CDSSs for the assessment and follow-up of kidney-transplanted patients built in this study are applicable to clinical practice.
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The present study aimed to investigate the effects of interprofessional education on healthcare providers' intentions to engage in an interprofessional shared decision-making (IP-SDM) process at emergency department and exploring the affecting factors on their intentions. ⋯ Our findings suggested that applying interprofessional education strategies could improve the learners' intention to engage in IP-SDM. Moreover, the results showed that the interprofessional collaboration among team members, adherence to the team-based care principles, and administrative support at different levels could be the influential factors the intentions of the participants to engage in IP-SDM.
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To investigate diabetes outcomes by long-term trajectories of patients' care settings among diabetes patients with regular follow-up. ⋯ Diabetes patients who were persistently treated in generalized care settings had health outcomes comparable to those who were persistently treated in specialized care settings. However, for elderly and less stable patients, regular diabetes care in specialized care settings was preferable.