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Results for “Knowledge Management”

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PubMed1994

Cancer pain: knowledge, attitudes of pharmacologic management.

The knowledge of, attitudes toward, and perceived barriers to pharmacologic management of cancer pain were compared between oncology nurses (N = 128) and long-term care facility (LTCF) nurses (N = 72) using an 82-item questionnaire. The oncology nurses were significantly more knowledgeable about pharmacologic management of cancer pain than were the nurses in LTCFs. However, the two groups did not differ in their attitudes toward pain management, with the exception that nurses in LTCFs were more likely to believe that patients over-report their pain. LTCF nurses were more likely than the oncology nurses to believe that inadequate assessment of pain, lack of equipment, and lack of skills to use equipment were impediments to pain management.

Adult↗

PubMed2002

The effect of Easy Breathing on asthma management and knowledge.

OBJECTIVE: To determine whether Easy Breathing, an asthma management program, improves adherence to national asthma guidelines. DESIGN: Before and after intervention trial. SETTING: Six urban primary care clinics in Hartford, Conn. PARTICIPANTS: Thirty-four primary care physicians, 37 midlevel practitioners, 32 nurses, and 69 pediatric and family practice residents and medical students. INTERVENTIONS: Knowledge was assessed before (pretest) and after (posttest) a training program and 12 to 18 months after (follow-up) implementing Easy Breathing. Questions were divided into factual, guideline recommendation, and guideline application. MAIN OUTCOME MEASURES: The percentage of correct responses on the pretest, posttest, and follow-up tests; clinician adherence to national guidelines; and clinician attitudes. RESULTS: The percentage of correct responses on the pretest was higher for physicians (mean, 61%; 95% confidence interval [CI], 57%-65%) than for midlevel practitioners (mean, 54%; 95% CI, 50%-59%) (P=.01). Correct responses increased significantly on the posttest for physicians (mean, 77%; 95% CI, 74%-81%) in all 3 subgroups of questions (P<.001) and for midlevel practitioners (mean, 69%; 95% CI, 63%-75%) overall and for factual and guideline questions. On the follow-up test, improvements in factual and guideline responses disappeared for all clinicians but were sustained for applied questions (mean, 78% [95% CI, 63%-94%] for physicians and 65% [95% CI, 51%-78%] for midlevel practitioners). Adherence to prescribing guidelines after implementing Easy Breathing was 93% to 99% and was associated with a 3-fold increase in inhaled corticosteroid prescriptions. Physicians reported that they had integrated Easy Breathing into practice but did not think this represented a substantial change. CONCLUSIONS: Easy Breathing increases clinicians' knowledge and use of national guidelines. Primary care physicians believe they are adhering to guidelines even when they are not.

Asthma↗

PubMed2006

The knowledge-value chain: A conceptual framework for knowledge translation in health.

This article briefly discusses knowledge translation and lists the problems associated with it. Then it uses knowledge-management literature to develop and propose a knowledge-value chain framework in order to provide an integrated conceptual model of knowledge management and application in public health organizations. The knowledge-value chain is a non-linear concept and is based on the management of five dyadic capabilities: mapping and acquisition, creation and destruction, integration and sharing/transfer, replication and protection, and performance and innovation.

Biomedical Research↗

PubMedDate not supplied

A survey of physicians' knowledge and management of venous thromboembolism.

A review of all patients diagnosed with venous thromboembolism (VTE) at an academic medical center from 1996 to 1998 revealed a wide variation in management and subsequent patient outcomes and a 30% increase in utilization of the vascular laboratory from the previous 2-year period. The purpose of this study was to determine physicians' knowledge and management strategies before the implementation of integrated care pathways for VTE. Mail surveys were sent to 650 physicians covering 3 academic medical centers. The disciplines targeted were from those physicians who had previously referred patients for any VTE screening examination. One-hundred and twenty-eight physicians (20%) completed the survey. Only 12% of the physicians were able to correctly identify all of the veins routinely imaged as either deep or superficial veins. Fifty-nine percent of the physicians incorrectly identified the superficial femoral vein of the thigh as a superficial vein, and 23% believed the popliteal vein to be a superficial vein. Only 17% of the respondents correctly classified the tibial-peroneal veins as deep veins. Approximately 70% of the physicians stated that they would not treat symptomatic isolated calf vein thrombosis, and, of those, only 42% said that they would obtain serial duplex scans to monitor for proximal propagation. Physicians underestimated the charges for all diagnostic screening tests, and only 14% were able to correctly identify the range of charges for a venous duplex scan. This survey of physicians demonstrated a lack of basic knowledge regarding lower extremity venous anatomy, charges for the different diagnostic tests used to diagnose VTE, and, most importantly, current treatment standards for VTE.

Adult↗

PubMed1992

Asthma knowledge and management in primary schools in south Auckland.

AIMS: to examine the management of asthma in primary schools and the school teachers' knowledge, confidence and attitude in managing the pupils with asthma. METHODS: forty-two primary schools in south Auckland were randomly selected to participate. Questionnaires were posted out to the principals and another questionnaire was given randomly to 253 teachers from these primary schools. RESULTS: 76% of the school principals surveyed returned the questionnaire; and 66% of the school teachers surveyed returned a separate questionnaire. The average incidence of asthma reported by school principals and school teachers was 9.9% and 12.6% respectively, which suggests underreporting of the diagnosis of asthma. In 81% of the schools a questionnaire was used to identify students with asthma when they first join the school. School teachers had good basic knowledge on asthma, however 33% of teachers did not know that Ventolin (salbutamol) is for symptomatic treatment and 58% and 65% of teachers did not know that Becotide (beclomethasone) and Intal (sodium cromoglycate) are prophylactic medications. CONCLUSIONS: we suggest that primary school teachers should receive further education on asthma, especially on practical aspects of asthma management.

Albuterol↗

PubMed1990

A research-knowledge system (ARKS) for storing, managing, and modeling knowledge from the scientific literature.

Nursing knowledge and nursing data are the foundation for nursing practice. Domain knowledge that is stored in the literature of nursing and related disciplines, if not in memory, needs to be available to nurses during the process of clinical decision making. Although the electromechanical technology for delivering knowledge is available, conceptual technology lags far behind. An informatics solution to the conceptual problem is provided by knowledge engineering, the branch of informatics that addresses such problems by developing methods for restructuring knowledge from one form into a form that is more useful. The purpose of this article is to describe a research program for engineering nursing knowledge that has resulted in the development of such a tool, a prototype computer system for storing, managing, and modeling research-knowledge. The system is called ARKS, acronym for A Research-Knowledge System.

Computer Simulation↗

PubMed1995

An integrated system to represent and manage medical knowledge.

This paper describes an integrated system in Prolog that permits the creation of a personal Knowledge Base to express and formalize specialist knowledge in medicine. Formalisms used are production rules and frames. The integrated system is able to manage data and knowledge stored in a database built in M Technology (MUMPS).

AIDS-Related Opportunistic Infections↗

PubMed2003

[Risk knowledge and management of blood exposure in operative room: results of a French national survey].

OBJECTIVES: To assess knowledge of risk factors of blood exposure in operative room and management after blood exposure. METHODS: A national survey was conducted towards 5000 surgeons drawn with hazard. RESULTS: The knowledge of the risk of viral contamination stay imperfect and the management after blood exposure is doubtful, and this last point is probably favoured by the absence of regulation in spite of guidelines from professional associations or societies. CONCLUSION: Knowledge of risk factors and more clear regulations could permit a better attitude in case of blood exposure.

Adult↗

PubMedDate not supplied

Covert leadership: notes on managing professionals. Knowledge workers respond to inspiration, not supervision.

The orchestra conductor is a popular metaphor for managers today--up there on the podium in complete control. But that image may be misleading, says Henry Mintzberg, who recently spent a day with Bramwell Tovey, conductor of the Winnipeg Symphony Orchestra, in order to explore the metaphor. He found that Tovey does not operate like an absolute ruler but practices instead what Mintzberg calls covert leadership. Covert leadership means managing with a sense of nuances, constraints, and limitations. When a manager like Tovey guides an organization, he leads without seeming to, without his people being fully aware of all that he is doing. That's because in this world of professionals, a leader is not completely powerless--but neither does he have absolute control over others. As knowledge work grows in importance, the way an orchestra conductor really operates may serve as a good model for managers in a wide range of businesses. For example, Mintzberg found that Tovey does a lot more hands-on work than one might expect. More like a first-line supervisor than a hands-off executive, he takes direct and personal charge of what is getting done. In dealing with his musicians, his focus is on inspiring them, not empowering them. Like other professionals, the musicians don't need to be empowered--they're already secure in what they know and can do--but they do need to be infused with energy for the tasks at hand. This is the role of the covert leader: to act quietly and unobtrusively in order to exact not obedience but inspired performance.

Communication↗

PubMed2005

Knowledge regarding management of tuberculosis among general practitioners in northern areas of Pakistan.

OBJECTIVE: To assess the knowledge of General Practitioners (GPs)in NWFP and northern areas of Pakistan regarding diagnosis and management of tuberculosis. METHODS: A cross-sectional survey of general practitioners (GPs) from North West Frontier Province (NWFP) and northern areas of Pakistan was done. The sampling strategy was convenience sampling. The data was collected on a structured questionnaire after taking verbal consent. RESULTS: Out of 88 GPs 43% regarded sputum microscopy and 22% chest radiograph as confirmatory tests for the diagnosis of pulmonary TB. During follow up of pulmonary TB patients, 32% doctors considered chest radiograph as the best investigation while sputum microscopy was chosen by only 28%. Eighty seven percent of GPs correctly identified TB as a droplet infection but 6% considered sexual contact to be the main mode of spread of this disease. Two third of the prescriptions, written for a 60 kg man with newly diagnosed smear-positive pulmonary TB, were not in line with national guidelines. Only 3% of the GPs knew all the five components of DOTS. CONCLUSION: Severe deficiencies were seen in the management of TB by GPs of Northern areas of Pakistan. National TB control Program must take appropriate measures to educate and train the GPs in TB management. Without involving the GPs, TB control will remain a problem in Pakistan).

Cross-Sectional Studies↗

PubMed2001

A consensus approach to maintain a knowledge based system in pathology.

The IDEM (Images and Diagnosis from Example in Medicine) software is a computerized environment able to store unambiguous descriptions of histopathologic images from pathologists. Medical imaging could benefit from such environments if they can easily and continuously be maintained. Within the IDEM environment, we developed a knowledge management module coupled with a consensus module to support knowledge acquisition and maintenance by the experts of the domain. Two pathologists, a senior and junior pathologist, reviewed fifty-three cases of breast pathology. Our findings indicate 1) that the IDEM knowledge management module allows experts to describe images by selecting terms and defining new ones if necessary, allowing the construction of a glossary for the domain and 2) that the consensus module, developed to store valid multi-experts cases, contributes also to validate new terms of the glossary and to refine semantic distance between terms. Such methodology could be applied to others highly evolving medical domains.

Artificial Intelligence↗

PubMed1990

[Tutelage and management: better knowledge for a better use].

At present, almost half of tutelages pronounced, are management's tutelages. However, legislation and rules of provision's patronage are complex and appear misunderstood with themselves who regularly use them in their practice. A reminder of legal feasibilities but also of their eventual disadvantages is appeared necessary to the authors. Who can do what and how? The roles of each protagonist are related in detail, with pragmatism.

France↗

PubMed1997

An investigation of dento-alveolar trauma and its treatment in an adolescent population. Part 2: Dentists' knowledge of management methods and their perceptions of barriers to providing care.

AIM: To assess dentists' knowledge of and perceived barriers to treatment of dental injuries. DESIGN: Cross-sectional postal questionnaire and personal interview. SUBJECTS AND METHODS: Questionnaires from 153 GDPs and 53 CDOs were received giving details of emergency options on 17 imaginary dental injuries and perceived barriers to treatment of trauma. Structured interviews with 21 of the GDPs and 19 CDOs seeking knowledge on diagnosis and long-term follow-up and treatment took place. Age and gender of dentist, type of practice and postgraduate courses attended were noted. MAIN OUTCOME MEASURES: Mean knowledge scores. RESULTS: Of a maximum of 14 correct responses on emergency treatment of injured teeth the mean was 7.5. Only 19% knew for how long avulsed teeth should be splinted. Of a maximum of 37 correct responses on long-term follow-up of treatment the mean was 15.4. Only 10% would correctly treat acute abscess on a traumatised tooth. 82% of dentists thought dental trauma should be treated in the primary care service, but 86% of GDPs thought fees for this type of treatment were too low. 72% of CDOs thought the treatment occupied too much clinic time and was not the responsibility of the CDS. CONCLUSIONS: Dentists in the primary care sector have insufficient knowledge to treat dental trauma.

Adolescent↗

PubMed2001

Intelligent knowledge retrieval for decision support in medical applications.

Knowledge management and retrieval are key issues to be addressed in the medical domain, where a large amount of information is generally available, and where the expert's skills need to be properly shared across the organisation, with the aim of improving the quality of care. Case Based Reasoning (CBR) is a very well suited methodology for the Knowledge Management task, when knowledge is in the operative form. Nevertheless, also well-assessed, formalised medical knowledge, such as clinical guidelines, should be made available to physicians in order to optimise their reasoning process. To take advantage of both knowledge types, we have defined a Multi Modal Reasoning methodology, that integrates CBR and Rule Based Reasoning, for supporting context detection, information retrieval and therapy revision in diabetes care.

Artificial Intelligence↗

PubMed2002

Bob's meltdown.

Annette Innella is just coming into the lunchroom at Concord Machines when Bob Dunn starts screaming at her. After throwing his lunch tray against the wall, he stomps out, leaving Annette stunned. Naturally, Annette, the new senior VP for knowledge management, is beside herself. She knows her proposal to establish a cross-functional knowledge management committee is progressive thinking for this oldline manufacturer, but Bob's reaction is totally over the line. If Bob stays, she goes--that's all there is to it. Bob is contrite, but he's under a lot of pressure. The general manager of the Services Group, he's just returned from a two-week trip around the globe to gear up his troops to beat revenue targets again, despite shrinking budgets and hiring freezes. And what does he see when he gets back? An e-mail from Annette requesting that two of his best people devote half their time to what he calls her "idiotic" Knowledge Protocols Group. He's carrying the company on his back, and she's throwing this nonsense at him. Graphics specialist Paula Chancellor is surprised. Sure, Bob's gruff, but his staff loves him, and he's the only one of the big shots who ever talks to her. But HR director Nathan Singer is incensed; Bob's never been a team player, Singer complains, and it's time he learned a lesson. CEO Jay Nguyen is in a bind. Bob is his top manager; he brings in all the money. And even though future revenues are going to have to come from somewhere else, Jay is not totally behind Annette's initiative in the current business climate. He can't afford to lose Bob. But if he reins in Annette, it will look like he's condoning Bob's outburst. What should he do? Four commentators offer advice in this fictional case study.

Administrative Personnel↗

PubMed2002

Management and knowledge of enteral nutrition in intensive care units in a city in Belgium.

The administration of enteral nutrition in intensive care unit (ICU) patients is largely managed by nurses. However, the degree of knowledge, interest, and training in this field can differ considerably among nurses and among ICUs. Such differences may lead to variations in the way in which enteral nutrition is used. To investigate these issues, a questionnaire survey was sent to the nursing staffs of 5 ICUs in Belgium. The response rate was 68%. Although theoretical knowledge of enteral nutrition was globally poor, its advantages over parenteral nutrition were usually known. Responses to questions related to practical issues associated with enteral feeding showed more institution-specific answers than interindividual differences.

Journal Article↗

PubMed2002

Indigenous knowledge informing management of tropical forests: the link between rhythms in plant secondary chemistry and lunar cycles.

This research used knowledge of the indigenous practice of timing nontimber forest product harvest with the full moon to demonstrate that chemicals controlling the decomposition rate of foliage fluctuate with the lunar cycle and may have developed as a result of plant-herbivore interactions. Indigenous knowledge suggests that leaves harvested during the full moon are more durable. Palm leaves harvested during the full moon had higher total C, hemicellulose, complex C and lower Ca concentrations. These chemical changes should make palm leaves less susceptible to herbivory and more durable when harvested during the full moon. This study proposes a mechanism by which plants in the tropics minimize foliage herbivory and influence the decomposition rates of senesced leaves and their durability, especially during the full moon. This research supports the need to use natural life cycles in managing forests and provides a scientific basis for an indigenous community's harvesting practice.

Animals↗

PubMed1999

Long-term outcome and disease control in near-fatal asthma.

Patients who have survived an episode of intubation and mechanical ventilation for acute respiratory failure due to a severe and unresponsive asthmatic attack are considered to have experienced a near-fatal asthma (NFA) attack. Such patients are at a higher risk of similar severe attacks and hence of death in the future. The aims of the study were to: (i) evaluate the outcome; (ii) identify any persistent deficiencies in asthma management, and (iii) assess self-management knowledge in survivors of NFA. Ninety-three consecutive patients who had been treated for NFA in the Intensive Care Unit of an urban teaching hospital in Singapore from 1992 to 1997 were studied. All hospital records were reviewed retrospectively. Survivors were then invited to attend a questionnaire interview and to have lung function tests performed. Of the original cohort (OC) of 93 patients with NFA (mean age 55.2 years), 18 (19% OC) patients (mean age 64 years) had died while in hospital and 75 (81% OC) patients survived the initial episode of NFA and were discharged home (DH). The long-term outcome of this DH group was: 13 patients had died (17% DH) and 62 (83% DH) survived. Of these survivors, 35 were interviewed while 27 declined or were not contactable. This interview yielded the following information: (i) Hospitalisation in the past year: 66% had no hospital admission; of the 31.4% who had 2 or more admissions, most had a further NFA attack. (ii) Health care: The majority of patients (71.4%) were monitored by a single doctor. (iii) Patient knowledge of disease management was deemed good to fair for trigger avoidance (77%), for appropriate drug usage (97%). (iv) Satisfactory inhaler skill (80%). NFA is associated with a high intrahospital and long-term mortality. Although most survivors of NFA appeared to have satisfactory care and a fair understanding of medication usage, a significant minority continue to pose much morbidity and risk for death.

Aged↗