Biomedical subjects

Zsolt Nagykaldi

Publications and source records attributed to Zsolt Nagykaldi.

5 recordsLinked to original sources

PubMed2005

Practice facilitators: a review of the literature.

BACKGROUND: Practice facilitators (PFs) are health care professionals who assist primary care clinicians in research and quality improvement projects. Although they have been used in Europe and Australia for more than 20 years, the concept is relatively new in the United States. The recent evolution of primary care practice-based research networks (PBRNs) has led to greater awareness and expansion of this concept. OBJECTIVES: This study's objective was to review the literature on PFs and describe their origin, training, funding, roles, methods they use, and their impact on patient care outcomes in primary care. METHODS: We searched four electronic databases from 1966 through the present, reviewing all articles pertaining to PFs in an effort to understand the history, training, financing, roles, methods, and impact of PFs. RESULTS: Since the early 1980s, PFs have worked with individual practices on relationship building, education, and quality improvement (QI), particularly in the area of prevention. A number of publications provide information on the roles of PFs in primary care and methods they use to enhance practices. Many prospective, uncontrolled studies and a few randomized, controlled trials have documented the effectiveness of PFs but usually in combination with other interventions. A number of primary care PBRNs in the United States have begun to use PFs as a way to bridge the gap between research and practice. Limited information has been published about the training and funding of PFs. CONCLUSIONS: The PF concept seems to be a useful practice enhancement approach in primary care.

Family Practice↗

PubMed2003

Diabetes Patient Tracker, a personal digital assistant-based diabetes management system for primary care practices in Oklahoma.

It has been demonstrated that electronic patient registries combined with a clinical decision support system have a significant positive impact on the documentation and delivery of services provided by health care professionals. While implementation of available commercial systems has not always been proven effective in a number of primary care practices, development and implementation of such a system in a practice-based research network might enhance successful implementation. Physicians in our practice-based research network (Oklahoma Physicians Resource/Research Network) initiated a project that aimed at designing, testing, and implementing a personal digital assistant-based diabetes management system. We utilized the "best practice" approach to determine the principles on which the application must operate. System development and beta testing were also accomplished based on the direct feedback of user clinicians. Practice Enhancement Assistants (PEAs) were available in the practices for assistance with implementation. Implementation of the Diabetes Patient Tracker (DPT) resulted in a significant improvement (p<0.05) in nine of 10 diabetic quality of care measures compared with pre-intervention levels in 20 primary care practices. Regular PEA visits similarly increased the number of foot exams and retinal exams performed in the last year (p=0.03 and 0.02, respectively). DPT is a low-cost, feasible, easily implementable, and very effective paper-less tool that significantly improves patient care and documentation in primary care practices.

Computer-Assisted Instruction↗

PubMedDate not supplied

Bridging the gap between public and private healthcare: Influenza-like illness surveillance in a practice-based research network.

This article describes the development, testing, and implementation of the OKAlert-ILI System, a bidirectional, dual-use influenza-like illness surveillance and messaging system, during the influenza seasons of 2003-2004 and 2004-2005 in the Oklahoma Physicians Resource/Research Network, a primary care practice-based research network. We describe how the Oklahoma Physicians Resource/Research Network connected 30 primary care providers to the Oklahoma State Department of Health and how surveillance results were analyzed and fed back to the clinicians on a weekly basis. We demonstrate the timeliness, sensitivity, specificity, acceptability, validity, flexibility, and cost of the system. Finally, we describe upgrades and enhancements to the system based on user evaluation and feedback.

Databases, Factual↗

PubMedDate not supplied

Associations between night sweats and other sleep disturbances: An OKPRN study.

PURPOSE: Surprisingly little is known about the causes and implications of night sweats. This study was designed to clarify further the associations between night sweats and sleep-related symptoms. METHODS: We undertook a cross-sectional study of consecutive adult patients seen in 10 primary care physicians' offices. Data were collected and transmitted by a personal digital assistant. Information included demographic variables; height, weight, and blood pressure; occurrence of a variety of sleep-related symptoms; and occurrence and severity of night sweats, day sweats, and hot flashes in the past month. For women, information about menstrual status was also obtained. RESULTS: Thirty-four percent of the 363 patients interviewed reported night sweats, one half of whom reported saturating their bedclothes. In the multivariate model, night sweats were associated with daytime tiredness (OR = 1.99; 95% CI, 1.12-3.53), waking up with a bitter taste in the mouth (OR = 1.94; 95% CI, 1.19-3.18), legs jerking during sleep (OR = 1.78; 95% CI, 1.05-3.00), and awakening with pain in the night (OR = 1.87; 95% CI, 1.16-2.99). CONCLUSIONS: Night sweats are associated with several sleep symptoms. Both night sweats and sleep disturbances are commonly experienced by adult primary care patients. When their patients report night sweats, clinicians should consider asking about sleep quality and sleep-related symptoms.

Adolescent↗

PubMedDate not supplied

Practice facilitators and practice-based research networks.

Practice facilitators (PFs) are health care professionals, who assist primary care practices in research and quality improvement activities. Their work goes beyond data collection and feedback and includes practice enhancement methods to facilitate system-level changes. PFs provide a framework for translating research into practice by building relationships, improving communication, facilitating change, and sharing resources in practice-based research networks (PBRNs). The work of PFs is funded from a variety of sources, including academic grants and renewable contracts with national, state, and local health care agencies. Limited information is available on cost-effectiveness of PF interventions. This article provides examples of how the PF model was implemented in 4 PBRNs in the United States.

Health Personnel↗