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Moulaei K, Iranmanesh E, Ahmadian L. The Impact of Health Technologies on Ostomy Care: A Systematic Review of Health Technologies Impact on Ostomy Care. J Wound Ostomy Continence Nurs 2023; 50:489-494. [PMID: 37966077 DOI: 10.1097/won.0000000000001021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
PURPOSE The purpose of this systematic review was to evaluate studies in which health information technology was used to improve ostomy care and management. METHODS Systematic literature review. SEARCH STRATEGIES The review was performed according to PRISMA Guidelines. Three scientific databases, Scopus, PubMed, and Web of Science, were searched with no time limitation using key words related to information technology and ostomy. The selection of articles and data collection were carried out by 2 reviewers and disagreements were resolved via discussion with a third, independent reviewer. FINDINGS The initial search of electronic databases retrieved 1679 elements; following removal of duplicate records, title and abstract review, and articles read in full for inclusion/exclusion criteria, 10 articles were included in the review. Analysis of findings from studies included in our review addresses technologies used to care for persons living with an ostomy. Elements were divided into 2 categories: (1) sensor-based wearable technologies, which were mostly used to assess the fecal output and fullness of ostomy pouching system, and (2) computer-based, tablet based, and smartphones platforms, which were used for teaching and learning. The most significant outcomes were increasing patients' knowledge and awareness of ostomy, enhancing patient's participation in self-care processes, and improving self-efficacy levels. IMPLICATIONS FOR PRACTICE We found limited research regarding the effectiveness of technology-based interventions on the management of ostomy patients. Findings of this systematic review suggest that the application of technologies has created a positive effect on the management of an ostomy, provided opportunities for enhancing self-efficacy, self-care, and self-management. The results of this study can be a basis for designing efficient technology-based systems for the management of ostomy.
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Affiliation(s)
- Khadijeh Moulaei
- Khadijeh Moulaei, PhD, Department of Health Information Technology, Faculty of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
- Elnaz Iranmanesh, Msc, Department of Information Technology Engineering, Faculty of Sciences, Islamic Azad University, Kerman, Iran
- Leila Ahmadian, PhD, Department of Health Information Sciences, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Elnaz Iranmanesh
- Khadijeh Moulaei, PhD, Department of Health Information Technology, Faculty of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
- Elnaz Iranmanesh, Msc, Department of Information Technology Engineering, Faculty of Sciences, Islamic Azad University, Kerman, Iran
- Leila Ahmadian, PhD, Department of Health Information Sciences, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Leila Ahmadian
- Khadijeh Moulaei, PhD, Department of Health Information Technology, Faculty of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
- Elnaz Iranmanesh, Msc, Department of Information Technology Engineering, Faculty of Sciences, Islamic Azad University, Kerman, Iran
- Leila Ahmadian, PhD, Department of Health Information Sciences, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
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Hollingworth S, Fenny AP, Yu SY, Ruiz F, Chalkidou K. Health technology assessment in sub-Saharan Africa: a descriptive analysis and narrative synthesis. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2021; 19:39. [PMID: 34233710 PMCID: PMC8261797 DOI: 10.1186/s12962-021-00293-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background Countries in Sub-Saharan Africa (SSA) are moving towards universal health coverage. The process of Health Technology Assessment (HTA) can support decisions relating to benefit package design and service coverage. HTA involves institutional cooperation with agreed methods and procedural standards. We systematically reviewed the literature on policies and capacity building to support HTA institutionalisation in SSA. Methods We systematically reviewed the literature by searching major databases (PubMed, Embase, etc.) until June 2019 using terms considering three aspects: HTA; health policy, decision making; and SSA. We quantitatively extracted and descriptively analysed content and conducted a narrative synthesis eliciting themes from the selected literature, which varied in study type and apporach. Results Half of the 49 papers identified were primary research studies and mostly qualitative. Five countries were represented in six of ten studies; South Africa, Ghana, Uganda, Cameroon, and Ethiopia. Half of first authors were from SSA. Most informants were policy makers. Five themes emerged: (1) use of HTA; (2) decision-making in HTA; (3) values and criteria for setting priority areas in HTA; (4) involving stakeholders in HTA; and (5) specific examples of progress in HTA in SSA. The first one was the main theme where there was little use of evidence and research in making policy. The awareness of HTA and economic evaluation was low, with inadequate expertise and a lack of local data and tools. Conclusions Despite growing interest in HTA in SSA countries, awareness remains low and HTA-related activities are uncoordinated and often disconnected from policy. Further training and skills development are needed, firmly linked to a strategy focusing on strengthening within-country partnerships, particularly among researchers and policy makers. The international community has an important role here by supporting policy- relevant technical assistance, highlighting that sustainable financing demands evidence-based processes for effective resource allocation, and catalysing knowledge-sharing opportunities among countries facing similar challenges. Supplementary Information The online version contains supplementary material available at 10.1186/s12962-021-00293-5.
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Affiliation(s)
- Samantha Hollingworth
- School of Pharmacy, University of Queensland, 20 Cornwall St, Woolloongabba, Brisbane, QLD, 4102, Australia. .,Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Ama Pokuaa Fenny
- Institute of Statistical, Social and Economics Research, University of Ghana, Accra, Ghana
| | - Su-Yeon Yu
- National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea
| | - Francis Ruiz
- iDSI, London School of Hygiene and Tropical Medicine, London, UK
| | - Kalipso Chalkidou
- The Global Fund To Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
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Belay M, Desta A, Smithson S, Meshesha M. Investigate knowledge management technology implementation for supporting decision making in Ethiopian health sectors. BMC Med Inform Decis Mak 2021; 21:146. [PMID: 33952240 PMCID: PMC8097940 DOI: 10.1186/s12911-021-01507-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/20/2021] [Indexed: 11/12/2022] Open
Abstract
Introduction Knowledge management technology is a key tool for facilitating and improving the quality of health care delivery in hospitals. However, the use and implementation of this technology is not an easy task. This study aims to investigate a knowledge management technology implementation and use in Ethiopian hospitals, with a particular reference to Jimma University Specialized Hospital. Methodology Information about challenges of knowledge management technology implementation was gathered using qualitative research methods, through conducting semi-structured interviews. Purposive sampling method was applied to select fifty-four participants from a well-defined population. Findings were first validated, according to published literature and research works, and then sorted into three main areas, such as current usage of KM technology to enhance and improve decision-making, factors affecting the implementation of KM technology Results This study revealed that the overall level of KM technology implementation in Jimma University Specialized hospital is still low. Conclusion Implementation and use of KM technology to improve the quality of hospital health services is needed. Thus, it suggested that hospital managers should make much more effort to develop a strategy and policy on the implementation and use of KM technology so that the hospital could improve the quality of healthcare services.
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Affiliation(s)
- Mniyichel Belay
- Department of Information Science, Jimma University, Jimma, Ethiopia.
| | - Amare Desta
- Information and Knowledge Management, Queen Mary University of London (QMUL), London, UK
| | - Steve Smithson
- Department of Management, London School of Economics, London, UK
| | - Million Meshesha
- School of Information Science, Addis Ababa University, Addis Ababa, Ethiopia
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Martins MMFPDS, Trindade LDL, Vandresen L, Leite MJMGC, Pereira CMG, Landeiro MJL. Technologies used by nursing managers in Portuguese hospitals. Rev Gaucha Enferm 2020; 41:e20190294. [DOI: 10.1590/1983-1447.2020.20190294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 03/06/2020] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: To analyze the association between the characteristics of nurse managers and the use of information technologies in Portuguese hospitals. Method: A cross-sectional quantitative study involving 138 nurse managers. The managers answered a questionnaire about the use of key information and communication technologies in management. The findings were submitted to descriptive and analytical statistical analysis. Results: Women predominated, with more than 25 years in the profession and more than ten in management. It showed that the managers identify the utility and easiness of a singular way for each technology, the use of which is influenced by the nurses' socio-occupational characteristics, their gender, specialization (having it or not), and the time of experience in services and management being significant. Conclusion: The study contributes to explain and predict the intention to use, as well as the mastery of technologies in hospital management, providing support of choice in the management of services and need for qualification for use.
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Affiliation(s)
| | - Letícia de Lima Trindade
- Universidade do Estado de Santa Catarina, Brasil; Universidade Comunitária da Região de Chapecó, Brasil
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Gachau S, Owuor N, Njagi EN, Ayieko P, English M. Analysis of Hierarchical Routine Data With Covariate Missingness: Effects of Audit & Feedback on Clinicians' Prescribed Pediatric Pneumonia Care in Kenyan Hospitals. Front Public Health 2019; 7:198. [PMID: 31380338 PMCID: PMC6646705 DOI: 10.3389/fpubh.2019.00198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 07/02/2019] [Indexed: 12/22/2022] Open
Abstract
Background: Routine clinical data are widely used in many countries to monitor quality of care. A limitation of routine data is missing information which occurs due to lack of documentation of care processes by health care providers, poor record keeping, or limited health care technology at facility level. Our objective was to address missing covariates while properly accounting for hierarchical structure in routine pediatric pneumonia care. Methods: We analyzed routine data collected during a cluster randomized trial to investigating the effect of audit and feedback (A&F) over time on inpatient pneumonia care among children admitted in 12 Kenyan hospitals between March and November 2016. Six hospitals in the intervention arm received enhance A&F on classification and treatment of pneumonia cases in addition to a standard A&F report on general inpatient pediatric care. The remaining six in control arm received standard A&F alone. We derived and analyzed a composite outcome known as Pediatric Admission Quality of Care (PAQC) score. In our analysis, we adjusted for patients, clinician and hospital level factors. Missing data occurred in patient and clinician level variables. We did multiple imputation of missing covariates within the joint model imputation framework. We fitted proportion odds random effects model and generalized estimating equation (GEE) models to the data before and after multilevel multiple imputation. Results: Overall, 2,299 children aged 2 to 59 months were admitted with childhood pneumonia in 12 hospitals during the trial period. 2,127 (92%) of the children (level 1) were admitted by 378 clinicians across the 12 hospitals. Enhanced A&F led to improved inpatient pediatric pneumonia care over time compared to standard A&F. Female clinicians and hospitals with low admission workload were associated with higher uptake of the new pneumonia guidelines during the trial period. In both random effects and marginal model, parameter estimates were biased and inefficient under complete case analysis. Conclusions: Enhanced A&F improved the uptake of WHO recommended pediatric pneumonia guidelines over time compared to standard audit and feedback. When imputing missing data, it is important to account for the hierarchical structure to ensure compatibility with analysis models of interest to alleviate bias.
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Affiliation(s)
- Susan Gachau
- Health Services Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya.,School of Mathematics, University of Nairobi, Nairobi, Kenya
| | - Nelson Owuor
- School of Mathematics, University of Nairobi, Nairobi, Kenya
| | - Edmund Njeru Njagi
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Philip Ayieko
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mike English
- Health Services Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya.,Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Houngbo PT, Coleman HLS, Zweekhorst M, De Cock Buning T, Medenou D, Bunders JFG. A Model for Good Governance of Healthcare Technology Management in the Public Sector: Learning from Evidence-Informed Policy Development and Implementation in Benin. PLoS One 2017; 12:e0168842. [PMID: 28056098 PMCID: PMC5215885 DOI: 10.1371/journal.pone.0168842] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 11/27/2016] [Indexed: 11/22/2022] Open
Abstract
Good governance (GG) is an important concept that has evolved as a set of normative principles for low- and middle-income countries (LMICs) to strengthen the functional capacity of their public bodies, and as a conditional prerequisite to receive donor funding. Although much is written on good governance, very little is known on how to implement it. This paper documents the process of developing a strategy to implement a GG model for Health Technology Management (HTM) in the public health sector, based on lessons learned from twenty years of experience in policy development and implementation in Benin. The model comprises six phases: (i) preparatory analysis, assessing the effects of previous policies and characterizing the HTM system; (ii) stakeholder identification and problem analysis, making explicit the perceptions of problems by a diverse range of actors, and assessing their ability to solve these problems; (iii) shared analysis and visioning, delineating the root causes of problems and hypothesizing solutions; (iv) development of policy instruments for pilot testing, based on quick-win solutions to understand the system’s responses to change; (v) policy development and validation, translating the consensus solutions identified by stakeholders into a policy; and (vi) policy implementation and evaluation, implementing the policy through a cycle of planning, action, observation and reflection. The policy development process can be characterized as bottom-up, with a central focus on the participation of diverse stakeholders groups. Interactive and analytical tools of action research were used to integrate knowledge amongst actor groups, identify consensus solutions and develop the policy in a way that satisfies criteria of GG. This model could be useful for other LMICs where resources are constrained and the majority of healthcare technologies are imported.
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Affiliation(s)
- P. Th. Houngbo
- Ministry of Health, Cotonou, Republic of Benin
- Polytechnic School, University of Abomey-Calavi, Abomey Calavi, Republic of Benin
- * E-mail:
| | - H. L. S. Coleman
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M. Zweekhorst
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Tj. De Cock Buning
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - D. Medenou
- Polytechnic School, University of Abomey-Calavi, Abomey Calavi, Republic of Benin
| | - J. F. G. Bunders
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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