Objectives: The medical record (MR) is a key document for hospitalized patients. Several audits have however demonstrated that much important information is often missing in hospital MR. We conducted this survey with the aim of improving the quality of MR in a geriatric unit.
Patients And Methods: A structured MR was elaborated and implemented in order to guide and record the assessment of patients admitted in our geriatric ward. MR of 54 consecutive patients admitted after implementation of the structured MR were studied and compared to those of 108 consecutive patients admitted on the preceeding year (classical MR). Quality of data collected at admission was assessed using a 33-item guide, proposed by 3 experts in geriatric medicine unaware of the structured MR studies. For each item, a binary score (present/absent) and a precision score were used. A validation study was conducted using the same methods in another geriatric ward which has not participated to development of the structured charts MR studied.
Results: For most items studied, information was present in a significantly higher proportion in structured MR than in classical MR. Likewise, the precision score was significantly higher in structured MR. The validation survey found analogous results.
Conclusion: Use of a structured MR significantly improves the quality of data collection at admission in geriatric units. This improvement appears to be related more to the use of the structured MR than the effect of developing a new tool.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Prevalence of Pulmonary Embolism in COVID-19 Positive Critically Ill Children.
Crit Care Explor
January 2025
Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine/Riley Children's Health, Indianapolis, IN.
Objectives: To investigate the prevalence of pulmonary embolism (PE) in children admitted to critical care diagnosed with COVID-19 infection.
Design: Retrospective database study.
Setting: Data reported to the Virtual Pediatric Systems, 2018-2021.
Comparative cardiovascular safety of romosozumab versus bisphosphonates in Japanese patients with osteoporosis: a new-user, active comparator design with instrumental variable analyses.
J Bone Miner Res
January 2025
Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, Japan.
This study analyzed the association of romosozumab, a human monoclonal antibody with bone-forming and bone resorption-inhibiting effects, and bisphosphonates with the development of cardiovascular disease among patients with osteoporosis. A new-user design was employed to address selection bias, and instrumental variable analysis was used to address confounding by indication. Japanese patients aged ≥40 years, diagnosed with osteoporosis or experienced a fragility fracture, were admitted to medical facilities covered by a commercial administrative claims database, and newly prescribed romosozumab or bisphosphonates after the commercialization of romosozumab in Japan (March 4, 2019) were included based on verification of a 180-day washout period.
View Article and Find Full Text PDFEffectiveness of oral vancomycin as prophylaxis against infection in hematopoietic stem cell transplant patients.
Antimicrob Steward Healthc Epidemiol
August 2024
Department of Pharmacy, Robert Wood Johnson University Hospital, New Brunswick, NJ, USA.
Objective: Patients receiving hematopoietic stem cell transplants (HSCT) are at increased risk for infection (CDI). The purpose of this study was to assess the effectiveness of oral vancomycin prophylaxis (OVP) for CDI in HSCT patients.
Design: Single-center, retrospective cohort.
Rise of the beta-lactams: a retrospective, comparative cohort of oral beta-lactam antibiotics as step-down therapy for hospitalized adults with acute pyelonephritis.
Antimicrob Steward Healthc Epidemiol
July 2024
Cardinal Health Innovative Delivery Solutions, Stafford, TX, USA.
Objective: The aim of this study was to determine if oral beta-lactam therapy is non-inferior to alternative therapy at discharge following inpatient treatment with an IV cephalosporin for acute pyelonephritis.
Design: Institutional Review Board (IRB)-approved, multicenter, retrospective, non-inferiority cohort (15% non-inferiority margin).
Setting: Six hospitals within two healthcare systems.
Burden of death associated with SARS-CoV-2 infection during the pandemic in Flint, Michigan (MI), mortality trends over the 2-year period: impact of social and health inequities.
Antimicrob Steward Healthc Epidemiol
August 2024
Department of Medicine, Hurley Medical Center, Flint, MI, USA.
Background: This cross-sectional study aims to determine the mortality trends in patients with SARS-CoV-2 infection during the pandemic in Flint, MI.
Methods: Records from 1,663 consecutive adult patients (≥18 years of age) with confirmed SARS-CoV-2 infection, admitted and discharged from our facility from 03/2020 through 02/2022, were abstracted and analyzed. Multivariable logistic regression analysis was performed to examine the association between study explanatory variables (ie, sex, age, co-morbidities, etc.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!