Journal of evaluation in clinical practice
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To validate codelists for defining a range of mental health (MH) conditions with primary care data, using a mixed qualitative and quantitative approach and without requiring external data. ⋯ We produced a comprehensive set of medical codes lists for 12 MH conditions validated by a combination of clinical consensus panel and quantitative cluster analysis with cross-validation.
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Comparative Study
Comparison of forearm and intra-arterial blood pressure measurements according to body and arm positions in obese patients.
Noninvasive blood pressure (BP) monitoring is very important also difficult for accurate diagnosis and monitor of obese patients. ⋯ Forearm systolic BP measurement, especially in the supine and half-sitting position with the arm below the heart level position, was best agreement with intra-arterial measurement, regarded as the gold standard. For this reason, it is more appropriate to use forearm BP measurement in obese patients monitored in intensive care to obtain accurate results.
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Implementation of clinical practice guidelines, an important strategy in the prevention of pressure injuries, enables the nurse to interpret evidence-based guideline recommendations, reduce errors, ensure compliance and standardisation of complex processes, manage patient-related risks and systematically regulate all preventable conditions. ⋯ This study demonstrated that the SPIPP- Adult Checklist 2.0 is a valid tool. Interventions using the evidence-based checklist should be integrated into the workflow and provide the best opportunity for successful and sustainable pressure injury prevention.
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Prostate cancer (PCa) represents the fifth cause of death in the male population worldwide. The prostate-specific antigen (PSA) test demonstrated poor accuracy to assess the presence of PCa. Thus, the PSA testing paradigm should be moved from the systematic screening approach to the early identification of men who are harbouring clinically significant disease. Accurate clinical-based tools to predict PCa should therefore be developed for general practice. We derived and validated a PCa predictive score using a primary care data source. ⋯ The PCa-HScore might guide the prescription of PSA and/or other clinical strategies in those men reporting certain levels of risk. A related decision support system could therefore be implemented in primary care.
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Understanding drivers of antibiotic use is key to limiting the development of antimicrobial resistance. Outpatient antibiotic prescribing rates vary substantially across and within states. Kentucky is one of the highest prescribing states, and the southeastern region has rates that are drastically higher than the national average and urban areas of the state. We sought to examine provider perceptions of antibiotic use in this rural area to more effectively guide future interventions and policy. ⋯ This study highlights unique challenges associated with antibiotic prescribing in rural areas. Findings will guide future interventions through adaptation of existing strategies to better serve this vulnerable population.