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Zhi S, Gao S, Sun J, Ma D, Zhao Y, He M, Zhu X, Dong Y, Aini B, Sun J. Virtual reality-based dementia educational programmes for formal and informal caregivers of people with dementia: A scoping review. J Clin Nurs 2024. [PMID: 38685766 DOI: 10.1111/jocn.17198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 04/12/2024] [Accepted: 04/19/2024] [Indexed: 05/02/2024]
Abstract
AIM To map evidence of the existing virtual reality-based dementia educational programmes and the effects of these educational programmes on dementia formal and informal caregivers. DESIGN A scoping review. METHODS A comprehensive search of nine databases was conducted to find studies from the inception of the databases to October 2023. Two authors independently screened the titles and abstracts related to the eligibility criteria. Full texts of potentially relevant studies were read by one author and checked by a second. Data extraction and synthesis using NVivo 12 were undertaken by one author and checked by two other authors. RESULTS Nineteen studies published between 2002 and 2022. The four randomised controlled studies and five qualitative studies were of moderate to good methodological quality. The 10 quasi-experimental studies were of weak to moderate quality. Fifteen virtual reality-based educational programmes had a positive influence on formal and informal caregivers, including improving caregivers' perceptions changing attitudes towards people with dementia, while the nursing competence of formal caregivers did not improve in short term. Educational programmes that covered dementia-related information and care strategies better improved the knowledge level of dementia formal and informal caregivers. CONCLUSIONS The qualitative and quantitative studies of moderate to good quality included in this study support the idea that virtual reality-based dementia educational programmes may be a safe and effective way and have potential benefits for improving knowledge, perceptions, attitudes and nursing competence. IMPACT This scoping review will provide an emerging teaching model for formal and informal caregivers of people with dementia and help them better understand the types and the influence of virtual reality-based dementia educational programmes. REPORTING METHOD PRISMA-ScR. NO PATIENT OR PUBLIC CONTRIBUTION Not required as this review in accordance with the aim to map existing literature from the dementia formal and informal caregivers' perspective.
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Affiliation(s)
- Shengze Zhi
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Shizheng Gao
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Juanjuan Sun
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Dongfei Ma
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Yanjie Zhao
- School of Nursing, Xinjiang Medical University, Xinjiang, People's Republic of China
| | - Meng He
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Xiangning Zhu
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Yueyang Dong
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Buheliqianmu Aini
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Jiao Sun
- School of Nursing, Jilin University, Changchun, People's Republic of China
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Al-Riyami AZ, Vanden Broeck J, Rahimi-Levene N, Das S, Saxon B, Lin Y, Stanworth SJ. E-learning in transfusion medicine: A scoping review. Transfusion 2023; 63:2362-2376. [PMID: 37876263 DOI: 10.1111/trf.17564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/06/2023] [Accepted: 09/08/2023] [Indexed: 10/26/2023]
Affiliation(s)
- Arwa Z Al-Riyami
- Department of Haematology, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Jana Vanden Broeck
- Department of Hematology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Federal Public Service Health, Food Chain Safety and Environment, Brussels, Belgium
| | - Naomi Rahimi-Levene
- Blood Bank, Shamir Medical Center, Zerifin, Israel
- Adelson School of Medicine, Ariel University, Ariel, Israel
| | - Soumya Das
- Department of Transfusion Medicine, All India Institute of Medical Sciences (AIIMS), Nagpur, Maharashtra, India
| | - Ben Saxon
- Department of Haematology/Oncology, Women's and Children's Hospital, Adelaide, Australia
| | - Yulia Lin
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
- University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada
| | - Simon J Stanworth
- Transfusion Medicine, NHS Blood and Transplant, Oxford, Oxford, UK
- Oxford University Hospitals NHS Trust, University of Oxford, Oxford, UK
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Uzuriaga M, Leiva J, Guillén-Grima F, Rua M, Yuste JR. Clinical Impact of Rapid Bacterial Microbiological Identification with the MALDI-TOF MS. Antibiotics (Basel) 2023; 12:1660. [PMID: 38136694 PMCID: PMC10740418 DOI: 10.3390/antibiotics12121660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Rapid microbiological reports to clinicians are related to improved clinical outcomes. We conducted a 3-year quasi-experimental design, specifically a pretest-posttest single group design in a university medical center, to evaluate the clinical impact of rapid microbiological identification information using MALDI-TOF MS on optimizing antibiotic prescription. A total of 363 consecutive hospitalized patients with bacterial infections were evaluated comparing a historical control group (CG) (n = 183), in which the microbiological information (bacterial identification and antibiotic susceptibility) was reported jointly to the clinician between 18:00 h and 22:00 h of the same day and a prospective intervention group (IG) (n = 180); the bacterial identification information was informed to the clinician as soon as it was available between 12:00 h and 14:00 h and the antibiotic susceptibility between 18:00 h and 22:00 h). We observed, in favor of IG, a statistically significant decrease in the information time (11.44 h CG vs. 4.48 h IG (p < 0.01)) from the detection of bacterial growth in the culture medium to the communication of identification. Consequently, the therapeutic optimization was improved by introducing new antibiotics in the 10-24 h time window (p = 0.05) and conversion to oral route (p = 0.01). Additionally, we observed a non-statistically significant decrease in inpatient mortality (global, p = 0.15; infection-related, p = 0.21) without impact on hospital length of stay. In conclusion, the rapid communication of microbiological identification to clinicians reduced reporting time and was associated with early optimization of antibiotic prescribing without worsening clinical outcomes.
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Affiliation(s)
- Miriam Uzuriaga
- Clinical Microbiology Service, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (M.U.); (M.R.)
| | - José Leiva
- Clinical Microbiology Service, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (M.U.); (M.R.)
- Healthcare Research Institute of Navarre (IdiSNA), 31008 Pamplona, Spain; (F.G.-G.); (J.R.Y.)
| | - Francisco Guillén-Grima
- Healthcare Research Institute of Navarre (IdiSNA), 31008 Pamplona, Spain; (F.G.-G.); (J.R.Y.)
- Department of Preventive Medicine, Clínica Universidad de Navarra, 31008 Pamplona, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, 46980 Madrid, Spain
- Department of Health Sciences, Public University of Navarra, 31008 Pamplona, Spain
| | - Marta Rua
- Clinical Microbiology Service, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (M.U.); (M.R.)
- Healthcare Research Institute of Navarre (IdiSNA), 31008 Pamplona, Spain; (F.G.-G.); (J.R.Y.)
| | - José R. Yuste
- Healthcare Research Institute of Navarre (IdiSNA), 31008 Pamplona, Spain; (F.G.-G.); (J.R.Y.)
- Service of Infectious Diseases, Clínica Universidad de Navarra, 31008 Pamplona, Spain
- Department of Internal Medicine, Clínica Universidad de Navarra, 31008 Pamplona, Spain
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4
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Zheng K, Xie Y, Dan L, Mao M, Chen J, Li R, Wang X, Hesketh T. Effectiveness of Educational Interventions for Health Workers on Antibiotic Prescribing in Outpatient Settings in China: A Systematic Review and Meta-Analysis. Antibiotics (Basel) 2022; 11:antibiotics11060791. [PMID: 35740197 PMCID: PMC9220158 DOI: 10.3390/antibiotics11060791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/30/2022] [Accepted: 06/07/2022] [Indexed: 02/01/2023] Open
Abstract
Educational interventions are considered an important component of antibiotic stewardship, but their effect has not been systematically evaluated in outpatient settings in China. This research aims to evaluate the effectiveness of educational interventions for health workers on antibiotic prescribing rates in Chinese outpatient settings. Eight databases were searched for relevant randomized clinical trials, non-randomized trials, controlled before–after studies and interrupted time-series studies from January 2001 to July 2021. A total of 16 studies were included in the systematic review and 12 in the meta-analysis. The results showed that educational interventions overall reduced the antibiotic prescription rate significantly (relative risk, RR 0.72, 95% confidence interval, CI 0.61 to 0.84). Subgroup analysis demonstrated that certain features of education interventions had a significant effect on antibiotic prescription rate reduction: (1) combined with compulsory administrative regulations (RR With: 0.65 vs. Without: 0.78); (2) combined with financial incentives (RR With: 0.51 vs. Without: 0.77). Educational interventions can also significantly reduce antibiotic injection rates (RR 0.83, 95% CI 0.74 to 0.94) and the inappropriate use of antibiotics (RR 0.61, 95% CI 0.51 to 0.73). The limited number of high-quality studies limits the validity and reliability of the results. More high-quality educational interventions targeting the reduction of antibiotic prescribing rates are needed.
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Affiliation(s)
- Kunhua Zheng
- People’s Hospital of Kaihua, Quzhou 324300, China; (K.Z.); (M.M.)
| | - Ying Xie
- Center for Global Health, Zhejiang University School of Medicine, Hangzhou 310000, China; (Y.X.); (L.D.); (J.C.); (R.L.); (T.H.)
| | - Lintao Dan
- Center for Global Health, Zhejiang University School of Medicine, Hangzhou 310000, China; (Y.X.); (L.D.); (J.C.); (R.L.); (T.H.)
| | - Meixian Mao
- People’s Hospital of Kaihua, Quzhou 324300, China; (K.Z.); (M.M.)
| | - Jie Chen
- Center for Global Health, Zhejiang University School of Medicine, Hangzhou 310000, China; (Y.X.); (L.D.); (J.C.); (R.L.); (T.H.)
| | - Ran Li
- Center for Global Health, Zhejiang University School of Medicine, Hangzhou 310000, China; (Y.X.); (L.D.); (J.C.); (R.L.); (T.H.)
- Institute for Global Health, University College London, London WC1E 6BT, UK
| | - Xuanding Wang
- Department of Antimicrobial Stewardship, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China
- Correspondence:
| | - Therese Hesketh
- Center for Global Health, Zhejiang University School of Medicine, Hangzhou 310000, China; (Y.X.); (L.D.); (J.C.); (R.L.); (T.H.)
- Institute for Global Health, University College London, London WC1E 6BT, UK
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Tudor Car L, Poon S, Kyaw BM, Cook DA, Ward V, Atun R, Majeed A, Johnston J, van der Kleij RMJJ, Molokhia M, V Wangenheim F, Lupton M, Chavannes N, Ajuebor O, Prober CG, Car J. Digital Education for Health Professionals: An Evidence Map, Conceptual Framework, and Research Agenda. J Med Internet Res 2022; 24:e31977. [PMID: 35297767 PMCID: PMC8972116 DOI: 10.2196/31977] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/07/2021] [Accepted: 11/21/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Health professions education has undergone major changes with the advent and adoption of digital technologies worldwide. OBJECTIVE This study aims to map the existing evidence and identify gaps and research priorities to enable robust and relevant research in digital health professions education. METHODS We searched for systematic reviews on the digital education of practicing and student health care professionals. We searched MEDLINE, Embase, Cochrane Library, Educational Research Information Center, CINAHL, and gray literature sources from January 2014 to July 2020. A total of 2 authors independently screened the studies, extracted the data, and synthesized the findings. We outlined the key characteristics of the included reviews, the quality of the evidence they synthesized, and recommendations for future research. We mapped the empirical findings and research recommendations against the newly developed conceptual framework. RESULTS We identified 77 eligible systematic reviews. All of them included experimental studies and evaluated the effectiveness of digital education interventions in different health care disciplines or different digital education modalities. Most reviews included studies on various digital education modalities (22/77, 29%), virtual reality (19/77, 25%), and online education (10/77, 13%). Most reviews focused on health professions education in general (36/77, 47%), surgery (13/77, 17%), and nursing (11/77, 14%). The reviews mainly assessed participants' skills (51/77, 66%) and knowledge (49/77, 64%) and included data from high-income countries (53/77, 69%). Our novel conceptual framework of digital health professions education comprises 6 key domains (context, infrastructure, education, learners, research, and quality improvement) and 16 subdomains. Finally, we identified 61 unique questions for future research in these reviews; these mapped to framework domains of education (29/61, 47% recommendations), context (17/61, 28% recommendations), infrastructure (9/61, 15% recommendations), learners (3/61, 5% recommendations), and research (3/61, 5% recommendations). CONCLUSIONS We identified a large number of research questions regarding digital education, which collectively reflect a diverse and comprehensive research agenda. Our conceptual framework will help educators and researchers plan, develop, and study digital education. More evidence from low- and middle-income countries is needed.
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Affiliation(s)
- Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Selina Poon
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Bhone Myint Kyaw
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - David A Cook
- Office of Applied Scholarship and Education Science, School of Continuous Professional Development, Mayo Clinic College of Medicine and Science, Division of General Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Victoria Ward
- Department of Pediatrics, Lucile Packard Children's Hospital, Stanford, CA, United States
| | - Rifat Atun
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard, Boston, MA, United States
| | - Azeem Majeed
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Jamie Johnston
- Stanford Center for Health Education's Digital MedIC Initiative, Stanford School of Medicine, Stanford University, Stanford, CA, United States
| | | | - Mariam Molokhia
- School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Florian V Wangenheim
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Martin Lupton
- Faculty of Medicine, Imperial College London, London, United Kingdom.,The Chelsea and Westminster Hospital, Chelsea, London, United Kingdom
| | - Niels Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Onyema Ajuebor
- Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Charles G Prober
- Stanford Center for Health Education's Digital MedIC Initiative, Stanford School of Medicine, Stanford University, Stanford, CA, United States
| | - Josip Car
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom.,Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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6
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Angarita-Díaz MDP, Bernal-Cepeda L, Bastidas-Legarda L, Forero-Escobar D, Ricaurte-Avendaño A, Mora-Reina J, Vergara-Mercado M, Herrera-Herrera A, Rodriguez-Paz M, Cáceres- Matta S, Fortich-Mesa N, Ochoa-Acosta EM. Impact of a virtual learning environment on the conscious prescription of antibiotics among Colombian dentists. PLoS One 2022; 17:e0262731. [PMID: 35089952 PMCID: PMC8797226 DOI: 10.1371/journal.pone.0262731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 01/04/2022] [Indexed: 12/17/2022] Open
Abstract
Appropriate antibiotic prescription contributes to reducing bacterial resistance; therefore, it is critical to provide training regarding this challenge. The objective of this study was to develop a virtual learning environment for antibiotic prescription and to determine its impact on dentists’ awareness, attitudes, and intention to practice. First, the learning content on multimedia resources was developed and distributed into three challenges that participants had to overcome. Then, a quasi-experimental study was performed in which the virtual learning environment was implemented on dentists from seven Colombian cities. The median of correct answers and the levels of awareness, attitudes, and intention to practice were compared before, immediately after, and 6-months post-intervention. Wilcoxon signed-rank and McNemar’s tests were used to determine the differences. A total of 206 participants who finished the virtual learning environment activities exhibited a favorable and statistically significant impact on the median of correct answers of awareness (p < 0.001), attitudes (p < 0.001), and intention to practice (p = 0.042). A significant increase occurred in the number of participants with a high level of awareness (p < 0.001) and a non-significant increase in participants with high levels of attitudes (p = 0.230) and intention to practice (p = 0.286). At 6 months, the positive effect on the median of correct answers on awareness and intention to practice persisted (p < 0.001); however, this was not evident for attitudes (p = 0.105). Moreover, there was a significant decrease in the number of participants who showed low levels of awareness (p = 0.019) and a slight increase in those with high levels of the same component (p = 0.161). The use of a virtual learning environment designed for dentists contributed to a rapid improvement in awareness and intention to practice antibiotic prescription; however, their attitudes and information retention need reinforcement.
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Affiliation(s)
| | | | - Leidy Bastidas-Legarda
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Diana Forero-Escobar
- Facultad de Odontología, Universidad Cooperativa de Colombia, Villavicencio, Colombia
| | | | - Julián Mora-Reina
- Facultad de Odontología, Universidad Cooperativa de Colombia, Villavicencio, Colombia
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Bosco A, McGarrigle L, Skelton DA, Laventure R, Townley B, Todd C. Make Movement Your Mission: Evaluation of an online digital health initiative to increase physical activity in older people during the COVID-19 pandemic. Digit Health 2022; 8:20552076221084468. [PMID: 35295764 PMCID: PMC8918976 DOI: 10.1177/20552076221084468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 02/14/2022] [Indexed: 11/23/2022] Open
Abstract
Objective To formatively evaluate the Make Movement Your Mission (MMYM) digital health initiative to promote physical activity (PA) levels and help avert the negative consequences of sedentary behaviours in older adults during the SARS-CoV2 pandemic. Methods Mixed-method study to explore activity levels, changes in physical function and Activities of Daily Living (ADLs), quality-of-life, social engagement, technology use, and accessibility. Survey data were analysed descriptively. Qualitative interviews were analysed using framework analysis. Results Forty-one respondents completed the survey (Mean age 68.4 (8.9) years; 34 Female), 68% aged ≥ 65 years. Average attendance was 14.3 sessions per week (3.5 h). 73% had been with MMYM for >1 year, 90% reported they were engaging in more movement on a typical day, and 75% reported improvement in ability to perform moderate PA. Since starting MMYM, participation in activities targeting strength, balance and flexibility increased (by 48%, 73% and 75%, respectively). 83% met strength and 90% balance PA guidelines for health (≥ 2x per week). Between 18% and 53% of respondents reported improvements in ADLs, 53% reported better quality-of-life, and 28% increased use of the internet. Eight participants were interviewed (Mean age 70.7 (6.7) years; 7 Female). Activity levels were promoted by having direct support from the instructor through Facebook messages pre and post live sessions, having group expectation about quality and level of engagement, having a sense of control and encouragement from others, MMYMs regularity, choice around level of engagement and accessibility. Noticing short-term outcomes in balance and posture helped boost confidence and continued participation. Conclusion Clinical trials need to robustly assess its effectiveness and acceptability.
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Affiliation(s)
- Alessandro Bosco
- Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Lisa McGarrigle
- Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | - Dawn A. Skelton
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Manchester, UK
| | | | | | - Chris Todd
- Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester, UK
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8
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Borek AJ, Campbell A, Dent E, Moore M, Butler CC, Holmes A, Walker AS, McLeod M, Tonkin-Crine S. Development of an intervention to support the implementation of evidence-based strategies for optimising antibiotic prescribing in general practice. Implement Sci Commun 2021; 2:104. [PMID: 34526140 PMCID: PMC8441243 DOI: 10.1186/s43058-021-00209-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/30/2021] [Indexed: 11/21/2022] Open
Abstract
Background Trials show that antimicrobial stewardship (AMS) strategies, including communication skills training, point-of-care C-reactive protein testing (POC-CRPT) and delayed prescriptions, help optimise antibiotic prescribing and use in primary care. However, the use of these strategies in general practice is limited and inconsistent. We aimed to develop an intervention to enhance uptake and implementation of these strategies in primary care. Methods We drew on the Person-Based Approach to develop an implementation intervention in two stages. (1) Planning and design: We defined the problem in behavioural terms drawing on existing literature and conducting primary qualitative research (nine focus groups) in high-prescribing general practices. We identified ‘guiding principles’ with intervention objectives and key features and developed logic models representing intended mechanisms of action. (2) Developing the intervention: We created prototype intervention materials and discussed and refined these with input from 13 health professionals and 14 citizens in two sets of design workshops. We further refined the intervention materials following think-aloud interviews with 22 health professionals. Results Focus groups highlighted uncertainties about how strategies could be used. Health professionals in the workshops suggested having practice champions, brief summaries of each AMS strategy and evidence supporting the AMS strategies, and they and citizens gave examples of helpful communication strategies/phrases. Think-aloud interviews helped clarify and shorten the text and user journey of the intervention materials. The intervention comprised components to support practice-level implementation: antibiotic champions, practice meetings with slides provided, and an ‘implementation support’ website section, and components to support individual-level uptake: website sections on each AMS strategy (with evidence, instructions, links to electronic resources) and material resources (patient leaflets, POC-CRPT equipment, clinician handouts). Conclusions We used a systematic, user-focussed process of developing a behavioural intervention, illustrating how it can be used in an implementation context. This resulted in a multicomponent intervention to facilitate practice-wide implementation of evidence-based strategies which now requires implementing and evaluating. Focusing on supporting the uptake and implementation of evidence-based strategies to optimise antibiotic use in general practice is critical to further support appropriate antibiotic use and mitigate antimicrobial resistance. Supplementary Information The online version contains supplementary material available at 10.1186/s43058-021-00209-7.
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Affiliation(s)
- Aleksandra J Borek
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
| | - Anne Campbell
- National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
| | - Elle Dent
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Michael Moore
- Primary Care Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Christopher C Butler
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Alison Holmes
- National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
| | - A Sarah Walker
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford, UK.,Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Monsey McLeod
- National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK.,Centre for Medication Safety and Service Quality, Pharmacy Department, Imperial College Healthcare NHS Trust, London, UK.,NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK
| | - Sarah Tonkin-Crine
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
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9
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Schwarz S, Martin DD, Büssing A, Kulikova O, Krafft H, Gwiasda M, Hamideh Kerdar S, Fingerhut I, Jenetzky E. Sociodemographic Characteristics and Interests of FeverApp Users. Int J Environ Res Public Health 2021; 18:3121. [PMID: 33803541 DOI: 10.3390/ijerph18063121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 12/17/2022]
Abstract
The FeverApp Registry is a model registry focusing on pediatric fever using a mobile app to collect data and present recommendations. The recorded interactions can clarify the relationship between user documentation and user information. This initial evaluation regarding features of participants and usage intensity of educational video, information library, and documentation of fever events covers the runtime of FeverApp for the first 14 months. Of the 1592 users, the educational opening video was viewed by 41.5%, the Info Library was viewed by 37.5%, and fever events were documented by 55.5%. In the current sample, the role of a mother (p < 0.0090), having a higher level of education (p = 0.0013), or being registered at an earlier date appear to be cues to take note of the training video, Info Library, and to document. The FeverApp was used slightly less by people with a lower level of education or who had a migration background, but at the current stage of recruitment no conclusion can be made. The user analyses presented here are plausible and should be verified with further dissemination of the registry. Ecological momentary assessment is used more than the information option, in line with the task of a registry. Data collection via app seems feasible.
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10
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Suppan L, Abbas M, Catho G, Stuby L, Regard S, Harbarth S, Achab S, Suppan M. Impact of a Serious Game on the Intention to Change Infection Prevention and Control Practices in Nursing Homes During the COVID-19 Pandemic: Protocol for a Web-Based Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e25595. [PMID: 33296329 PMCID: PMC7744143 DOI: 10.2196/25595] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/02/2020] [Accepted: 12/08/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Nursing home residents are at high risk of complications and death due to COVID-19. Lack of resources, both human and material, amplifies the likelihood of contamination in these facilities where a single employee can contaminate dozens of residents and colleagues. Improving the dissemination of and adhesion to infection prevention and control (IPC) guidelines is therefore essential. Serious games have been shown to be effective in developing knowledge and in increasing engagement, and could motivate nursing home employees to change their IPC practices. OBJECTIVE Our aim is to assess the impact of "Escape COVID-19," a serious game designed to enhance knowledge and application of IPC procedures, on the intention of nursing home employees to change their IPC practices. METHODS We will carry out a web-based randomized controlled trial following the CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile Health Applications and Online Telehealth) guidelines and incorporating relevant elements of CHERRIES (Checklist for Reporting Results of Internet E-Surveys). Participants will be randomized to either the control or the serious game (intervention) group. First, both groups will be asked to answer a questionnaire designed to gather demographic data and assess baseline knowledge. The control group will then receive a quick reminder of the current national guidelines and links to IPC guidelines for health care professionals, while the other group will play the game. Both groups will then have to answer a second questionnaire designed to assess their willingness to change their IPC practices after having followed their respective material. After completing this questionnaire, they will be granted access to the material presented to the group they were not assigned to and receive a course completion certificate. The primary outcome will be the proportion of participants willing to change their IPC practices according to group. Secondary outcomes will include the analysis of specific questions detailing the exact changes considered by the participants. Factors associated with participant willingness or reluctance to change behavior will also be assessed. Attrition will also be assessed at each stage of the study. RESULTS The study protocol has been presented to our regional ethics committee (Req-2020-01262), which issued a declaration of no objection as such projects do not fall within the scope of the Swiss federal law on human research. Data collection began on November 5, 2020, and should be completed by December 4, 2020. CONCLUSIONS This study should determine whether "Escape COVID-19," a serious game designed to improve compliance with COVID-19 safe practices, modifies the intention to follow IPC guidelines among nursing home employees. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/25595.
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Affiliation(s)
- Laurent Suppan
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Mohamed Abbas
- Infection Control Programme, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Gaud Catho
- Infection Control Programme, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | | | - Simon Regard
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.,Division of General Surgeon, Geneva Directorate of Health, Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Programme, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Sophia Achab
- Specialized Facility in Behavioral Addictions ReConnecte, Geneva University Hospitals, Geneva, Switzerland.,WHO Collaborating Center in Training and Research in Mental Health, University of Geneva, Geneva, Switzerland
| | - Mélanie Suppan
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
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Angarita-Díaz MDP, Bernal-Cepeda L, Rodriguez-Paz M, Vergara-Mercado M, Herrera-Herrera A, Forero-Escobar D, Mora-Reina J, Ochoa-Acosta EM, Maya-Giraldo M, Caceres-Matta S, Tamayo J, Martinez-Cajas C, Fortich-Mesa N, Bermudez-Reyes P, Vergara-Bobadilla H. Prescribing antibiotics by dentists in Colombia: Toward a conscientious prescription. J Public Health Dent 2020; 81:100-112. [PMID: 33104249 DOI: 10.1111/jphd.12416] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 09/15/2020] [Accepted: 10/09/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Inappropriate prescription of antibiotics contributes to antibiotic resistance. Therefore, the objective of this study was to determine the awareness, attitudes, and intention to practice of dentists prescribing antibiotics in Colombia in order to design a virtual learning environment on this subject. METHODS In a descriptive study across seven cities, 700 dentists from different Colombian cities were requested to complete a validated questionnaire containing five sections: general information, awareness on antibiotic effectiveness and antibiotic resistance, attitudes regarding prescription decision, intention to practice concerning clinical cases, and complementary information. The level of awareness, attitudes, and intention to practice was determined and Chi-square test was used to determine the existence of significant differences among cities. RESULTS The majority of dentists showed a medium level regarding the number of correct answers on awareness (62.4 percent) and attitudes (88.7 percent) and a high level on intention to practice (91.7 percent). Common errors within the awareness section included the meaning of the term "antibiotic resistance" (35 percent) and most dentists were not convinced that such resistance could be derived from prescription of antibiotics (51.2 percent). In the attitudes section, only 45 percent declared that they prescribe antibiotics based mainly on symptoms, and the intention to practice section showed a significant percentage of unnecessary prescription (51 percent for pacemaker users) or absence of prescription (53.9 percent for ventricular septal defect) in antibiotic prophylaxis for infectious endocarditis (IE). CONCLUSION The dentists interviewed should be trained and made aware of antibiotic resistance, microbiological and clinical foundations, and current antibiotic prophylaxis guidelines.
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Affiliation(s)
| | | | | | | | | | - Diana Forero-Escobar
- School of Dentistry, Cooperative University of Colombia, Villavicencio, Colombia
| | - Julián Mora-Reina
- School of Dentistry, Cooperative University of Colombia, Villavicencio, Colombia
| | | | | | | | - Julián Tamayo
- School of Dentistry, University Institute of Colombian Colleges, Cali, Colombia
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12
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Poss-Doering R, Kuehn L, Kamradt M, Glassen K, Wensing M. Applying Digital Information Delivery to Convert Habits of Antibiotic Use in Primary Care in Germany: Mixed-Methods Study. J Med Internet Res 2020; 22:e18200. [PMID: 32960773 PMCID: PMC7578814 DOI: 10.2196/18200] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/29/2020] [Accepted: 08/11/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Antimicrobial resistance is an important global health issue. In Germany, the national agenda supports various interventions to convert habits of antibiotic use. In the CHANGE-3 (Converting Habits of Antibiotic Use for Respiratory Tract Infections in German Primary Care) study, digital tools were applied for information delivery: tablet computers in primary care practices, e-learning platforms for medical professionals, and a public website to promote awareness and health literacy among primary care physicians, their teams, and their patients. OBJECTIVE This study is embedded in the process evaluation of the CHANGE-3 study. The aim of this study was to evaluate the acceptance and uptake of digital devices for the delivery of health-related information to enhance awareness and change habits of antibiotic use in primary care in Germany. METHODS This study used a convergent-parallel mixed-methods design. Audio-recorded semistructured telephone interviews were conducted with physicians, nonphysician health professionals, and patients in the CHANGE-3 program. Pseudonymized verbatim transcripts were coded using thematic analysis. In-depth analysis was performed based on the inductive category of information provision via digital information tools. Identified themes were related to the main postulates of Diffusion of Innovations theory (DIT) to provide an explanatory frame. In addition, data generated through a structured survey with physicians and nonphysician health professionals in the program were analyzed descriptively and integrated with the qualitative data to explore the complementarity of the findings. RESULTS Findings regarding the acceptance and uptake of digital devices were related to three postulates of DIT: innovation characteristics, communication channels, and unanticipated consequences. Participants considered the provided digital educative solutions to be supportive for promoting health literacy regarding conversion of habits of antibiotic use. However, health care professionals found it challenging to integrate these solutions into existing routines in primary care and to align them with their professional values. Low technology affinity was a major barrier to the use of digital information in primary care. Patients welcomed the general idea of introducing health-related information in digital formats; however, they expressed concerns about device-related hygiene and the appropriateness of the digital tools for older patients. CONCLUSIONS Patients and medical professionals in German primary care are reluctant to use digital devices for information and education. Using a Diffusion of Innovations approach can support assessment of existing barriers and provide information about setting-specific preconditions that are necessary for future tailoring of implementation strategies. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN) 15061174; http://www.isrctn.com/ISRCTN15061174.
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Affiliation(s)
- Regina Poss-Doering
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Lukas Kuehn
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Martina Kamradt
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Katharina Glassen
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
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13
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Martinengo L, Yeo NJY, Markandran KD, Olsson M, Kyaw BM, Car LT. Digital health professions education on chronic wound management: A systematic review. Int J Nurs Stud 2019; 104:103512. [PMID: 32086027 DOI: 10.1016/j.ijnurstu.2019.103512] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 12/17/2019] [Accepted: 12/20/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Continuing education is crucial for healthcare professionals to keep up with research but attending classroom lectures is a major barrier. Chronic wound management is increasingly relevant for continuous professional training. Digital education offers learning tailored to individual needs and could be an effective alternative to healthcare professionals' training. However, the effectiveness of digital education for chronic wound management training has not been explored. OBJECTIVES To assess the effectiveness of digital education in improving healthcare professionals' knowledge, attitudes, practical skills and behaviour change on chronic wound management, and their satisfaction with the intervention. DESIGN This systematic review follows Cochrane methodology and is one of a series of reviews on the use of digital education for health professions education. Protocol registration: PROSPERO CRD42018109971 DATA SOURCES: Searches were conducted in MEDLINE, Embase, Web of Science, ERIC, PsycINFO, CINAHL, CENTRAL, and ProQuest Dissertation and Theses Database. REVIEW METHODS We included randomised control trials, cluster randomised control trials and quasi-randomised control trials comparing digital or blended education with traditional learning, no intervention or other forms of digital or blended education for pre- or post-registration healthcare professionals in chronic wound management. A narrative summary of findings is presented. RESULTS Seven studies (1,404 participants) were included. All studies investigated interventions for nursing students or professionals working in hospitals or community settings, and all but one study focused on pressure ulcers. Five studies (935 participants) assessed post-intervention knowledge, and indicated that digital education was more effective than no intervention, while blended learning was superior to exclusive digital education. Three studies (543 participants) assessed post-intervention skills and reported mixed results. One study (140 participants) compared post-intervention behaviour change and satisfaction with blended and online digital education, and reported no difference in behaviour between the groups, and higher satisfaction with blended education. For knowledge retention up to six months, digital education was more effective than no intervention, while blended learning was superior to digital education. The risk of bias in included studies was mostly high or unclear. CONCLUSIONS Digital education on chronic wound management appears to be less effective than blended education and more effective than no intervention in improving knowledge among nurses and nursing students. Data for other outcomes is scarce and inconclusive. Future studies should assess participants' skills, attitudes, satisfaction and behaviour change; cost-effectiveness and potential untoward effects of digital education, compare digital education to other learning modalities and include other healthcare professionals in diverse clinical settings.
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Affiliation(s)
- Laura Martinengo
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road Level 18, Singapore 308232, Singapore.
| | - Natalie Jia Ying Yeo
- Laboratory of Molecular and Vascular Medicine, Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Level 3, Singapore 636921, Singapore.
| | - Kasturi D/O Markandran
- Laboratory of Muscle and Cardiac Biophysics, Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Level 3, Singapore 636921, Singapore.
| | - Maja Olsson
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road Level 18, Singapore 308232, Singapore; Institute of Health and Biomedical Innovation, Queensland University of Technology, 149 Victoria Park Rd, Kelvin Grove, Queensland 4059, Australia
| | - Bhone Myint Kyaw
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road Level 18, Singapore 308232, Singapore; Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road Level 18, Singapore 308232, Singapore.
| | - Lorainne Tudor Car
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road Level 18, Singapore 308232, Singapore; Department of Primary Care and Public Health, School of Public Health, Imperial College London, The Reynolds Building, St Dunstan's Road, London W6 8RP, UK.
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14
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Affiliation(s)
- Onyema Ajuebor
- Health Workforce Department, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Nandini Shetty
- National Infection Service Laboratories, Public Health England, London, England
| | - Karen Mah
- Antimicrobial Resistance Department, World Health Organization, Geneva, Switzerland
| | - Giorgio Cometto
- Health Workforce Department, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
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