checklists

清单
  • 文章类型: Journal Article
    充血性心力衰竭(HF)的动态管理仍然是一个具有挑战性的临床问题。最近的研究集中在HF诊所的作用,护士从业人员和疾病管理计划,以减少HF再入院。这项试点研究是一项比较教练干预的务实因素研究,智能手机提醒系统干预和两种干预措施结合治疗作为常规(TAU)。我们确定在随机化之前两种方式对患者都是可接受的。54名患者被随机分为四组。COACH组在入组6个月后未再入院,而SMARTPHONEREMINDER组则为18%。两者干预组为8%,TAU组为13%。尽管COACH和联合(两者)组的钠消耗量在3个月时较低,但所有四组均保持了中等至高的药物依从性。这项初步研究表明,使用支持措施,包括教练和电话提醒,需要在更大的试验中确认,对再住院有有益的影响。
    Ambulatory management of congestive heart failure (HF) continues to be a challenging clinical problem. Recent studies have focused on the role of HF clinics, nurse practitioners and disease management programmes to reduce HF readmissions. This pilot study is a pragmatic factorial study comparing a coach intervention, a SMARTPHONE REMINDER system intervention and BOTH interventions combined to Treatment as USUAL (TAU). We determined that both modalities were acceptable to patients prior to randomisation. Fifty-four patients were randomised to the four groups. The COACH group had no readmissions for HF 6 months after enrolment compared with 18% for the SMARTPHONE REMINDER Group, 8% for the BOTH intervention group and 13% for TAU. Medium-to-high medication adherence was maintained in all four groups although sodium consumption was lower at 3 months for the COACH and combined (BOTH) groups. This pilot study suggests a beneficial effect on rehospitalisation with the use of support measures including coaches and telephone reminders that needs confirmation in a larger trial.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目的:许多研究已经检查了癫痫手术的结果,然而,报告的细节水平的差异阻碍了我们在患者组中广泛应用这些发现的能力.在其他临床研究领域建立的报告标准提高了结果的质量和通用性,确保从研究这些手术中获得的见解可以有效地使未来的患者受益。本研究旨在评估目前癫痫手术研究的报告标准,并确定潜在的差距和需要加强的领域。
    方法:增强健康研究质量和透明度(EQUATOR)存储库从成立到2023年4月27日被访问,产生了561个可用的报告标准。对于癫痫和/或神经外科研究的适用性,报告标准进行了两次独立的手动审查。报告标准必须涵盖人体研究的以下方面:(1)癫痫/癫痫手术的报告标准和(2)神经外科手术的报告标准。第三作者解决了分歧。前五名神经外科,神经学,和医学期刊也通过GoogleScholar的引文索引进行识别,并进行检查以确定他们推荐的相关报告标准以及这些标准是否在EQUATOR注册。
    结果:在561个EQUATOR报告标准中,181与癫痫手术有关。一个与癫痫有关,六个是专门针对外科研究的,9例与神经/神经外科研究有关。其余165个报告标准适用于不同学科的研究,包括但不限于CONSORT(合并报告标准)。STROBE(加强流行病学观察研究的报告),和PRISMA(系统评价和荟萃分析的首选报告项目)。这些与癫痫手术结果相关的必需报告因素均无,如癫痫持续时间或磁共振成像结果。
    结论:缺乏癫痫手术特有的报告标准,反映了可能影响出版物质量的标准差距。通过一套具体的报告标准来改善这一差距,将确保癫痫手术研究的设计更加透明和严格。
    OBJECTIVE: Numerous studies have examined epilepsy surgery outcomes, yet the variability in the level of detail reported hampers our ability to apply these findings broadly across patient groups. Established reporting standards in other clinical research fields enhance the quality and generalizability of results, ensuring that the insights gained from studying these surgeries can benefit future patients effectively. This study aims to assess current reporting standards for epilepsy surgery research and identify potential gaps and areas for enhancement.
    METHODS: The Enhancing the Quality and Transparency of Health Research (EQUATOR) repository was accessed from inception to April 27, 2023, yielding 561 available reporting standards. Reporting standards were manually reviewed in duplicate independently for applicability to epilepsy and/or neurosurgery research. The reporting standards had to cover the following aspects in human studies: (1) reporting standards for epilepsy/epilepsy surgery and (2) reporting standards for neurosurgery. Disagreements were resolved by a third author. The top five neurosurgery, neurology, and medicine journals were also identified through Google Scholar\'s citation index and examined to determine the relevant reporting standards they recommended and whether those were registered with EQUATOR.
    RESULTS: Of the 561 EQUATOR reporting standards, 181 were pertinent to epilepsy surgery. One was related to epilepsy, six were specific to surgical research, and nine were related to neurological/neurosurgical research. The remaining 165 reporting standards were applicable to research across various disciplines and included but were not limited to CONSORT (Consolidated Standards of Reporting Trails), STROBE (Strengthening the Reporting of Observational Studies in Epidemiology), and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). None of these required reporting factors associated with epilepsy surgery outcomes, such as duration of epilepsy or magnetic resonance imaging findings.
    CONCLUSIONS: Reporting standards specific to epilepsy surgery are lacking, reflecting a gap in standards that may affect the quality of publications. Improving this gap with a set of specific reporting standards would ensure that epilepsy surgery studies are more transparent and rigorous in their design.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    简介世界卫生组织(WHO)安全手术检查表显着降低了常规手术室病例的发病率和死亡率。然而,常规手术室病例与在产程和分娩单元进行剖宫产之间的工作流程和流程存在显著差异.这项研究的目的是为分娩和分娩单位以及剖宫产调整WHO安全手术清单,以改善沟通和患者安全。方法由所有主要利益相关者组成的多学科小组审查并修订了WHO安全手术清单,使其更适用于剖宫产手术。对新的安全剖腹产检查表进行了测试,然后将其集成到电子病历中,并在分娩和分娩单位中使用。制定了具体的剖宫产安全态度问卷,已验证,并在实施前和实施后一年进行管理。结果初次实施后,安全剖宫产检查表的使用率大于95%。据报告,工作人员对几个关键领域的剖宫产态度问卷有了显著改善,包括感觉在手术开始时就可以获得所有必要的信息,减少通信中断和延迟,和更少的问题,有关不知道谁是在手术过程中负责。讨论实施安全剖宫产检查表被工作人员成功采用,并证明了员工对我们单位几个关键安全问题的看法有所改善。应进行其他研究,以确定该干预措施的临床结果是否与使用WHO安全手术检查表的结果相当。
    Introduction The World Health Organization (WHO) Safe Surgery Checklist significantly decreases morbidity and mortality in regular operating room cases. However, significant differences in workflow and processes exist between regular operating room cases and cesarean sections performed on the labor and delivery unit. The aim of this study is to adapt the WHO Safe Surgery Checklist for the labor and delivery unit and cesarean sections to improve communication and patient safety. Methods A multidisciplinary team consisting of all major stakeholders reviewed and revised the WHO Safe Surgery Checklist making it more applicable to cesarean section operations. The new Safe Cesarean Section Checklist was tested and then integrated into the electronic medical record and utilized on the labor and delivery unit. A specific cesarean section safety attitudes questionnaire was developed, validated, and administered prior to and one year after implementation. Results Usage of the Safe Cesarean Section Checklist was greater than 95% after initial implementation. Significant improvements were reported by the staff on the cesarean section attitudes questionnaire for several key areas including the feeling that all necessary information was available at the beginning of the procedure, decreases in communication breakdowns and delays, and fewer issues related to not knowing who was in charge during the procedure. Discussion Implementation of the Safe Cesarean Section Checklist was successfully adopted by the staff, and improvements in staff perceptions of several key safety issues on our unit were demonstrated. Additional studies should be undertaken to determine if clinical outcomes from this intervention are comparable to those seen with the use of the WHO Safe Surgery Checklist.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    我们讨论了两种经验验证的行为改变方法的使用-清单和目标设定-并设计了清单,以帮助行为分析师改善其行为服务,使其更具文化响应性和对创伤的了解。我们还提供了试点数据,以评估清单和目标设定的使用情况,以将文化响应和创伤知情的做法纳入为公立学校学生设计的行为支持计划中。培训计划对两名参与者都有效,参与者的每周目标与观察到的行为计划变化相对应。此外,两位参与者都强烈同意该检查表有价值且易于使用,并报告了他们在培训后实施文化应对和创伤知情实践的感知能力的提高.
    We discuss the use of two empirically validated behavior-change methods-checklists and goal setting-and designed a checklist to assist behavior analysts in improving their behavioral services to be more culturally responsive and trauma informed. We also present pilot data evaluating the use of the checklist and goal setting on the inclusion of culturally responsive and trauma-informed practices in behavior support plans designed for students in a public school. The training package was effective for both participants, and the participants\' weekly goals corresponded to the observed changes in their behavior plans. Moreover, both participants strongly agreed that the checklist was valuable and easy to use and reported increases in their perceived abilities to implement culturally responsive and trauma-informed practices posttraining.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    目标:开发两个道德清单,以评估(i)研究项目中道德问题的管理和(ii)对医疗保健实验室专业人员道德行为的认识。
    方法:IFCC伦理工作组成员基于相关文献进行综合讨论。
    结果:这份临床研究项目清单应该有助于在提交给IRB或其同等机构之前从伦理角度评估研究建议,从而降低废品率,并导致更多的时间有效的项目。旨在评估实验室医学道德行为的清单可用于自我评估(内部审核)和第三方执行的认证/认可过程。
    结论:这些清单是简单但功能强大的工具,可用于指导专业人员在实践中遵守道德原则,特别是在发展中国家,认可的伦理委员会可能很难找到。
    OBJECTIVE: To develop two ethical checklists to evaluate (i) management of ethical concerns in research projects and (ii) awareness of ethical conduct of healthcare laboratory professionals.
    METHODS: Comprehensive discussion among the members of IFCC Task Force on Ethics based on pertinent literature.
    RESULTS: This Checklist for Clinical Research Projects should be useful to evaluate research proposals from an ethical perspective before submitting it to an IRB or its equivalent, thereby diminishing rejection rates and resulting in more time-effective projects. The checklist designed to evaluate the ethical conduct in laboratory medicine could be useful for self evaluation (internal audits) and for certification/accreditation processes performed by third parties.
    CONCLUSIONS: These checklists are simple but powerful tools useful to guide professionals to adhere to ethical principles in their practice, especially in developing countries where accredited ethics committees may be difficult to find.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    清单是一种用于指导任务执行的认知辅助工具;在许多高风险行业中,它们已被用作重要的安全干预措施。由于易于访问并且被认为易于设计和实施,它们已成为许多医疗环境中无处不在的工具。然而,对何时使用清单以及如何设计清单缺乏了解,导致医疗环境中这种干预的使用不合格和效果不理想。清单的设计必须考虑许多因素,包括它打算解决的错误类型,目标用户的经验和技术能力,以及将使用的特定工具或设备。尽管已经提出了几种分类方法来对清单类型进行分类,有,然而,关于选择最合适的检查表类型的指导很少,用户专业知识的差异如何影响检查表的设计。因此,我们开发了一种算法,为清单的使用和设计提供指导。算法,旨在支持概念和内容/设计决策,是根据清单文献的综合以及我们在临床环境中开发和观察清单使用的经验而创建的。然后,我们根据主题专家在每次迭代时提供的反馈,迭代地改进算法。最终的算法包括两个部分:第一部分提供了最适合检查表的系统安全问题的指导,第二部分提供了关于应根据最终用户的专业知识制定哪种类型的清单的指导。
    Checklists are a type of cognitive aid used to guide task performance; they have been adopted as an important safety intervention throughout many high-risk industries. They have become an ubiquitous tool in many medical settings due to being easily accessible and perceived as easy to design and implement. However, there is a lack of understanding for when to use checklists and how to design them, leading to substandard use and suboptimal effectiveness of this intervention in medical settings. The design of a checklist must consider many factors including what types of errors it is intended to address, the experience and technical competencies of the targeted users, and the specific tools or equipment that will be used. Although several taxonomies have been proposed for classifying checklist types, there is, however, little guidance on selecting the most appropriate checklist type, nor how differences in user expertise can influence the design of the checklist. Therefore, we developed an algorithm to provide guidance on checklist use and design. The algorithm, intended to support conception and content/design decisions, was created based on the synthesis of the literature on checklists and our experience developing and observing the use of checklists in clinical environments. We then refined the algorithm iteratively based on subject matter experts\' feedback provided at each iteration. The final algorithm included two parts: the first part provided guidance on the system safety issues for which a checklist is best suited, and the second part provided guidance on which type of checklist should be developed with considerations of the end users\' expertise.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    方法:范围审查。
    目的:回顾文献并总结关于术中神经监测(IONM)警报和术中脊髓损伤(ISCI)管理的检查表和算法的信息。
    方法:从开始到2022年1月26日搜索MEDLINE®,以及灰色文献的来源。我们试图从以下来源获得指南和/或共识声明:美国神经肌肉和电诊断医学协会(AANEM),美国神经病学会(AAN),美国临床神经生理学会,NASS(北美脊柱协会),和其他脊柱外科组织。
    结果:在报告ISCI管理策略的16项研究中,两个是根据Delphi方法进行的共识会议的出版物,八个是回顾性队列研究.其余六项研究是叙述性综述,提出了术中检查清单和IONM警报的管理策略。值得注意的是,56%的纳入研究仅关注接受脊柱畸形手术的患者。术中考虑因素和在ISCI事件中采取的措施分为三类:i)麻醉学,ii)神经生理学/技术,和iii)手术管理策略。
    结论:关于针对IONM警报和可能的ISCI的管理策略的比较有效性和危害的文献很少。迫切需要开发标准化的检查表和护理途径,以避免和最大程度地减少术后神经系统后遗症的风险。
    METHODS: Scoping Review.
    OBJECTIVE: To review the literature and summarize information on checklists and algorithms for responding to intraoperative neuromonitoring (IONM) alerts and management of intraoperative spinal cord injuries (ISCIs).
    METHODS: MEDLINE® was searched from inception through January 26, 2022 as were sources of grey literature. We attempted to obtain guidelines and/or consensus statements from the following sources: American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM), American Academy of Neurology (AAN), American Clinical Neurophysiology Society, NASS (North American Spine Society), and other spine surgery organizations.
    RESULTS: Of 16 studies reporting on management strategies for ISCIs, two were publications of consensus meetings which were conducted according to the Delphi method and eight were retrospective cohort studies. The remaining six studies were narrative reviews that proposed intraoperative checklists and management strategies for IONM alerts. Of note, 56% of included studies focused only on patients undergoing spinal deformity surgery. Intraoperative considerations and measures taken in the event of an ISCI are divided and reported in three categories of i) Anesthesiologic, ii) Neurophysiological/Technical, and iii) Surgical management strategies.
    CONCLUSIONS: There is a paucity of literature on comparative effectiveness and harms of management strategies in response to an IONM alert and possible ISCI. There is a pressing need to develop a standardized checklist and care pathway to avoid and minimize the risk of postoperative neurologic sequelae.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目的:调查人工智能(AI)在放射治疗领域的应用的研究在质量方面表现出很大的差异。这项研究的目的是评估评分文章的透明度和偏见,特别关注基于AI的细分和治疗计划。使用修改后的PROBAST和TRIPOD检查表,以便为未来的指南开发人员和审阅者提供建议。
    方法:使用Delphi过程讨论和修改了TRIPOD和PROBAST检查表项目。达成共识后,2组3合著者对2篇文章进行了评分,以评估可用性并进一步优化调整后的清单。最后,所有合著者对10篇文章进行了评分。计算Fleiss\'kappa以评估观察者之间协议的可靠性。
    结果:37个TRIPOD项目中的3个和32个PROBAST项目中的5个被认为是不相关的。项目中的一般术语(例如,多变量预测模型,预测因子)被修改为与AI特定术语一致。第一轮得分后,制定了进一步改进的项目,例如,通过防止使用子问题或主观词,并添加关于如何评分项目的澄清。使用最终共识列表对10篇文章进行评分,在61个项目中,只有2个项目的kappa在0.4或更高的统计学意义上显示出实质性的一致性.对于41个项目,未获得统计学上显着的κ,表明多个观察者之间的一致性水平仅归因于偶然。
    结论:我们的研究显示,采用适应的TRIPOD和PROBAST检查表的可靠性得分较低。尽管这些清单在开发和报告过程中显示出巨大的价值,这引起了人们对此类清单对AI应用的科学文章进行客观评分的适用性的担忧。在制定或修订准则时,在不引入偏见的情况下,考虑它们对文章的适用性是至关重要的。
    OBJECTIVE: Studies investigating the application of Artificial Intelligence (AI) in the field of radiotherapy exhibit substantial variations in terms of quality. The goal of this study was to assess the amount of transparency and bias in scoring articles with a specific focus on AI based segmentation and treatment planning, using modified PROBAST and TRIPOD checklists, in order to provide recommendations for future guideline developers and reviewers.
    METHODS: The TRIPOD and PROBAST checklist items were discussed and modified using a Delphi process. After consensus was reached, 2 groups of 3 co-authors scored 2 articles to evaluate usability and further optimize the adapted checklists. Finally, 10 articles were scored by all co-authors. Fleiss\' kappa was calculated to assess the reliability of agreement between observers.
    RESULTS: Three of the 37 TRIPOD items and 5 of the 32 PROBAST items were deemed irrelevant. General terminology in the items (e.g., multivariable prediction model, predictors) was modified to align with AI-specific terms. After the first scoring round, further improvements of the items were formulated, e.g., by preventing the use of sub-questions or subjective words and adding clarifications on how to score an item. Using the final consensus list to score the 10 articles, only 2 out of the 61 items resulted in a statistically significant kappa of 0.4 or more demonstrating substantial agreement. For 41 items no statistically significant kappa was obtained indicating that the level of agreement among multiple observers is due to chance alone.
    CONCLUSIONS: Our study showed low reliability scores with the adapted TRIPOD and PROBAST checklists. Although such checklists have shown great value during development and reporting, this raises concerns about the applicability of such checklists to objectively score scientific articles for AI applications. When developing or revising guidelines, it is essential to consider their applicability to score articles without introducing bias.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    在过去50年中,早产儿和危重病儿的生存和健康状况有了显著改善,在进行良好的新生儿研究的支持下。然而,新生儿研究难以进行,原因有很多,在这一人群中获得知情同意进行研究提出了一些独特的伦理和后勤挑战。在这篇文章中,我们探索促进同意过程的方法,包括检查表的作用,以支持有意义的知情同意新生儿临床试验。结论:作者为设计和实施为新生儿临床研究量身定制的有效同意清单提供了实践指导。
    The survival and health of preterm and critically ill infants have markedly improved over the past 50  years, supported by well-conducted neonatal research. However, newborn research is difficult to undertake for many reasons, and obtaining informed consent for research in this population presents several unique ethical and logistical challenges. In this article, we explore methods to facilitate the consent process, including the role of checklists to support meaningful informed consent for neonatal clinical trials. CONCLUSION: The authors provide practical guidance on the design and implementation of an effective consent checklist tailored for use in neonatal clinical research.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    设计和开发安全系统一直是医疗保健领域的持续挑战,特别是在手术环境中。为了促进安全,安全文化,即,关于安全管理的共同价值观,被认为是高质量的关键驱动力,安全的医疗保健交付。然而,改变组织文化,使其强调和促进安全往往是一个难以捉摸的目标。安全手术清单是提高安全文化和手术护理安全性的创新工具,但是关于安全手术检查表有效性的证据好坏参半。我们研究了在实施安全手术检查表期间管理实践的变化与感知安全文化的变化之间的关系。采用前测后设计和调查方法,我们在一个领先的医院网络中的42家普通急性护理医院的全国样本中评估了安全手术检查表的实施情况.我们使用世界管理调查衡量了管理者(n=99)的感知管理实践。我们使用安全手术实践调查测量了临床手术室人员的术前安全性和安全文化(N=2,380(2016);N=1,433(2017))。我们连续两年收集数据。多变量线性回归分析表明,在实施安全手术清单后,管理实践的变化与整体安全文化和感知的团队合作之间存在显着关系。
    Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e., shared values regarding safety management, is considered a key driver of high-quality, safe healthcare delivery. However, changing organizational culture so that it emphasizes and promotes safety is often an elusive goal. The Safe Surgery Checklist is an innovative tool for improving safety culture and surgical care safety, but evidence about Safe Surgery Checklist effectiveness is mixed. We examined the relationship between changes in management practices and changes in perceived safety culture during implementation of safe surgery checklists. Using a pre-posttest design and survey methods, we evaluated Safe Surgery Checklist implementation in a national sample of 42 general acute care hospitals in a leading hospital network. We measured perceived management practices among managers (n = 99) using the World Management Survey. We measured perceived preoperative safety and safety culture among clinical operating room personnel (N = 2,380 (2016); N = 1,433 (2017)) using the Safe Surgical Practice Survey. We collected data in two consecutive years. Multivariable linear regression analysis demonstrated a significant relationship between changes in management practices and overall safety culture and perceived teamwork following Safe Surgery Checklist implementation.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

公众号