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Tanveer S, Khilji M, Gul N, Shah SH, Haroon H, Khan L, Tahir A, Nawaz A, Khilji A, Hassan RE. Enhancing Documentation Precision in Ophthalmic Surgery: A Quality Improvement Project. Cureus 2023; 15:e51274. [PMID: 38283467 PMCID: PMC10822054 DOI: 10.7759/cureus.51274] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2023] [Indexed: 01/30/2024] Open
Abstract
Background Effective clinical documentation, particularly operative notes, is essential for maintaining healthcare standards and fostering interdisciplinary communication. This study focuses on improving the quality of ophthalmic operative notes by adopting the Royal College of Surgeons (RCS) guidelines for good surgical practice. Methodology A retrospective cross-sectional audit at Khyber Teaching Hospital, Pakistan, assessed 138 operative notes against the RCS criteria. After an educational session and the placement of memory aids in operation theaters, a re-audit of 125 notes was conducted. Parameters were selectively applied based on relevance to specific cases, and omissions were discussed with the local ethical committee. Results The initial audit revealed deficiencies in 10 critical areas, with only three parameters exceeding 85% accuracy. The re-audit showed significant improvement across these parameters, achieving documentation of 85.3% of all criteria. Paired t-test results indicated a substantial difference in documentation quality before and after interventions. Conclusions A combined strategy involving surgeon education, memory aids, and adherence to established standards significantly enhances operative note quality. The study underscores the importance of sustained reinforcement mechanisms for continuous improvements in documentation practices.
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Affiliation(s)
| | - Maryum Khilji
- Ophthalmology, Khyber Teaching Hospital, Peshawar, PAK
| | - Nazli Gul
- Ophthalmology, Khyber Teaching Hospital, Peshawar, PAK
| | - Syed Hassnain Shah
- Orthopaedics and Trauma, Pakistan Institute of Medical Sciences, Islamabad, PAK
| | - Hamza Haroon
- Surgery, Ayub Teaching Hospital, Abbottabad, PAK
| | - Luqman Khan
- Orthopaedics and Trauma, Khyber Teaching Hospital, Peshawar, PAK
| | - Asna Tahir
- Ophthalmology, Khyber Teaching Hospital, Peshawar, PAK
| | - Ahad Nawaz
- Accident and Emergency, District Headquarters Teaching Hospital, Dera Ismail Khan, PAK
| | - Ayesha Khilji
- Internal Medicine, Hayatabad Medical Complex, Peshawar, PAK
| | - Rao E Hassan
- Surgery, Ayub Teaching Hospital, Abbottabad, PAK
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Burbaite A, Leeworthy S, Hirst L, Mioshi E, Clare L, Ahmed S. Suitability of memory aids and strategies for people with posterior cortical atrophy: protocol for a scoping review. Syst Rev 2023; 12:58. [PMID: 36998057 PMCID: PMC10061751 DOI: 10.1186/s13643-023-02187-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/06/2023] [Indexed: 03/31/2023] Open
Abstract
Background Posterior cortical atrophy (PCA) is a neurodegenerative syndrome characterised by progressive visuospatial and visuoperceptual impairment. Recent research shows that memory impairment can also occur as an early symptom of the condition and that the impairment can be ameliorated by providing support in the memory recall phase, for example, by presenting a related cue. In Alzheimer’s disease (AD), which is defined by an amnestic syndrome, memory aids and strategies have been used to help support everyday memory, which in turn can have a positive impact on patient and carer outcomes. Similar support for PCA could be achieved by using memory aids and strategies which help to encode and/or retrieve information, yet there are currently no guidelines for memory strategies that may be suitable in PCA. Due to the central visual disorder that defines PCA, careful consideration is needed when making recommendations. Methods A scoping review will be conducted of published studies that have assessed memory aids and strategies in people with AD and related dementias where memory is considered a core or supplementary feature, with the aim of distinguishing those that may be suitable or adaptable for PCA. The systematic search will include the electronic databases MEDLINE, PsycINFO and CINAHL, using search terms for dementia and memory aids and strategies identified in pilot searches. Findings will be mapped and described based on methods used, population, clinical data and memory aids and strategies identified. Discussion The scoping review will give an overview of the memory aids and strategies used in people with AD and related dementias and identify characteristics, modality and pragmatics to evaluate their suitability and adaptability for a PCA population. Tailored memory support strategies for people living with PCA could improve memory performance, with knock-on positive effects on patient and carer outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s13643-023-02187-4.
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Affiliation(s)
- A. Burbaite
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK
| | - S. Leeworthy
- grid.410421.20000 0004 0380 7336Department of Paediatric Neuropsychology, University Hospitals Bristol and Weston NHS Trust, Bristol, UK
| | - L. Hirst
- Academy Library, Royal United Hospitals, Bath, UK
| | - E. Mioshi
- grid.8273.e0000 0001 1092 7967School of Health Sciences, University of East Anglia, Norwich, UK
| | - L. Clare
- grid.8391.30000 0004 1936 8024Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, UK
| | - S. Ahmed
- grid.9435.b0000 0004 0457 9566School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
- grid.4991.50000 0004 1936 8948Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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Buehne KL, Rosdahl JA, Muir KW. Aiding Adherence to Glaucoma Medications: A Systematic Review. Semin Ophthalmol 2021; 37:313-323. [PMID: 34402384 DOI: 10.1080/08820538.2021.1963788] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To provide a comprehensive assessment of the strategies studied to date that focus on improving glaucoma medication adherence. METHODS A systematic review of the literature was conducted in MEDLINE (PubMed), Embase (Elsevier), and Scopus (Elsevier) from inception to March 1, 2021, of publications describing a device or strategy used to improve glaucoma medication adherence. RESULTS 42 studies described by 50 papers were included. Five categories were identified: reminder systems, medication simplifications, behavioral change programs, education, and alternative engagement strategies. CONCLUSION Most studies (40 of the 42) addressed the question of improved adherence directly, with 26 finding improved adherence. Notably, 14 examined the clinical effects of the intervention, either in terms of intraocular pressure (IOP) or visual fields. Only three found an improvement in IOP. None demonstrated a between group difference in visual field progression.
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Affiliation(s)
- Kristen L Buehne
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Jullia A Rosdahl
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Kelly W Muir
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA.,Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, USA
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Chester H, Beresford R, Clarkson P, Entwistle C, Gillan V, Hughes J, Orrell M, Pitts R, Russell I, Symonds E, Challis D. The Dementia Early Stage Cognitive Aids New Trial (DESCANT) intervention: A goal attainment scaling approach to promote self-management. Int J Geriatr Psychiatry 2021; 36:784-793. [PMID: 33271639 DOI: 10.1002/gps.5479] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/16/2020] [Accepted: 11/29/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVES This study investigated goals identified by people with dementia and their carers to promote the self-management of symptoms and abilities; measured achievement using goal attainment scaling (GAS); and explored the reflections of Dementia Support Practitioners (DSPs) facilitating it. METHODS AND DESIGN Within this pragmatic randomised trial, DSPs gave memory aids, training and support to people with mild to moderate dementia and their carers at home. Data were collected across seven NHS Trusts in England and Wales (2016-2018) and abstracted from intervention records and semi-structured interviews with DSPs delivering the intervention, supplemented by a subset of the trial dataset. Measures were created to permit quantification and descriptive analysis and interview data thematically analysed. A GAS measure for this intervention in this client group was derived. RESULTS Engagement was high across the 117 participants and 293 goals were identified. These reflected individual circumstances and needs and enabled classification and assessment of their attainment. Seventeen goal types were identified across six domains: self-care, household tasks, daily occupation, orientation, communication, and well-being and safety. On average participants achieved nominally significant improvement regarding the specified goals of 1.4 with standard deviation of 0.6. Five interviews suggested that DSPs' experiences of goal setting were also positive. CONCLUSIONS GAS is useful for assessing psychosocial interventions for people with early-stage dementia. It has a utility in identifying goals, promoting self-management and providing a personalised outcome measure. There is a strong case for exploring whether these clear benefits translate to other interventions in other populations in other places.
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Affiliation(s)
- Helen Chester
- School of Medicine, Institute of Mental Health, The University of Nottingham, Nottingham, UK
| | - Rebecca Beresford
- Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Paul Clarkson
- Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Charlotte Entwistle
- Department of Psychology, Fylde College, Lancaster University, Lancaster, UK
| | - Vincent Gillan
- Faculty of Biology, Medicine and Health, Formerly of School of Health Sciences, The University of Manchester, Manchester, UK
| | - Jane Hughes
- School of Medicine, Institute of Mental Health, The University of Nottingham, Nottingham, UK
| | - Martin Orrell
- School of Medicine, Institute of Mental Health, The University of Nottingham, Nottingham, UK
| | - Rosa Pitts
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Ian Russell
- Swansea Trials Unit, Medical School, Swansea University, Swansea, Wales, UK
| | - Eileen Symonds
- School of Medicine, Institute of Mental Health, The University of Nottingham, Nottingham, UK
| | - David Challis
- School of Medicine, Institute of Mental Health, The University of Nottingham, Nottingham, UK
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Abstract
BACKGROUND The use of mobile devices to deliver healthcare has not yet been exploited in neuropsychological rehabilitation. Smartphones have the potential to serve as multi-functional memory aids. AIMS To investigate whether patients attending a clinic for mixed memory problems own smartphones, to determine whether this could be a widely applicable medium to use as a memory aids device. METHODS A questionnaire on smartphone ownership was given to an opportunity sample of consecutive patients attending a neuropsychiatry and memory disorders outpatient clinic. Data were collected in 2012 and repeated 12 months later in 2013 to assess changes over time. RESULTS Ownership of mobile phones was stable between 2012 (81%) and 2013 (85%), but ownership of smartphones showed a significant increase (from 26% to 40%). Age negatively predicted smartphone ownership. CONCLUSION Despite cognitive or psychiatric problems, our patient group are as likely to own a mobile phone as a member of the general population. Ownership levels are at 40% and likely to increase in the future. Exploring how smartphones and their apps could function as memory aids is likely to be useful for a large enough number of patients to be clinically worthwhile.
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Affiliation(s)
- Ellen M Migo
- a Academic Unit of Neuropsychiatry, Department of Psychological Medicine , Institute of Psychiatry, King's College London , London , UK and
| | - Becky I Haynes
- a Academic Unit of Neuropsychiatry, Department of Psychological Medicine , Institute of Psychiatry, King's College London , London , UK and
| | - Lara Harris
- a Academic Unit of Neuropsychiatry, Department of Psychological Medicine , Institute of Psychiatry, King's College London , London , UK and
| | - Kim Friedner
- a Academic Unit of Neuropsychiatry, Department of Psychological Medicine , Institute of Psychiatry, King's College London , London , UK and
| | - Kate Humphreys
- b Neuropsychiatry and Memory Disorders Clinic, South London and Maudsley NHS Foundation Trust, St Thomas's Hospital , London , UK
| | - Michael D Kopelman
- a Academic Unit of Neuropsychiatry, Department of Psychological Medicine , Institute of Psychiatry, King's College London , London , UK and.,b Neuropsychiatry and Memory Disorders Clinic, South London and Maudsley NHS Foundation Trust, St Thomas's Hospital , London , UK
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