PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Knowledge Management”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 757 records · Page 42Linked to original sources
PubMed2001

Iatrogenic injuries in gynecologic cancer surgery.

Iatrogenic injury is always an unwelcome event at the time of surgery. Prior history of multiple laparatomies, radiation therapy, or a distorted pelvic anatomy caused by a malignancy are all factors that may make iatrogenic injury a likely event. In these situations, complications at times can be considered unavoidable. Injuries during benign surgical procedures also can be difficult to manage, especially if not diagnosed at the time of occurrence. Operative knowledge to manage the more commonly encountered complications must be in the repertoire of all surgeons, including those dealing with abdominopelvic malignancies. This article reviews the more common genitourinary, gastrointestinal, and neural injuries encountered during gynecological surgical procedures and discusses basic management strategies.

Female↗
PubMed2001

Anemia management practices in peritoneal dialysis patients. Case study of the anemic patient.

The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative recommends a target hemoglobin (Hb) level of 11 to 12 g/dL (hematocrit [Hct] of 33% to 36%) for both peritoneal dialysis and hemodialysis patients. However, national tracking data indicate that peritoneal dialysis patients have consistently lower Hb/Hct levels. This article focuses on anemia management challenges that are unique to the peritoneal dialysis population. Nursing knowledge and management of Epoetin alfa dosing and administration techniques, peritonitis and other infections, and iron supplementation may help improve anemia-related outcomes in peritoneal dialysis patients.

Adult↗
PubMed2006

What is the impact of theoretical knowledge on children's nurses' post-operative pain management practices? An exploratory study.

Despite the availability of the evidence to guide pain management practices, practices are often sub-optimal with children experiencing moderate to severe pain post-operatively. Limited theoretical knowledge about managing pain has been suggested as one reason for this. Several studies have identified gaps in nurses' theoretical knowledge. However, the affect of theoretical knowledge on pain management practices has not been explored. This explored whether there is a relationship between nurses' theoretical knowledge and the quality of their practices. Nurses (n=13) on one children's surgical ward were shadowed for a five-hour period during two-four shifts. Data about post-operative pain management practices were collected using a pain management checklist and field notes. Nurses (n=12) also completed the revised pain management knowledge test. Questionnaire scores were compared to the observational data. No positive relationship was found between nurses' level of theoretical knowledge and how well they actually managed pain. Nurses did not appear to routinely apply theoretical knowledge in practice. This may explain, at least in part, why pain management practices remain poor despite the evidence to guide practice being readily available. The hypothesis, put forward in other studies, that increasing nurses' theoretical knowledge about pain will improve practices may be overly simplistic.

Adult↗
PubMed2001

Safe use of detergent enzymes in the workplace.

This article gives a detailed description of a program to control workplace exposure to enzymes during manufacture of laundry detergents. We believe this same program could, in large part, be re-applied to control exposure to enzymes in other industries or to control exposure to other industrial allergens. We chose to publish at this time because we believe enzyme use will increase in the future. The information contained here could potentially help new users ensure safe deployment of enzyme technology. Also, we have recently acquired new knowledge to improve our management system: this knowledge could help current enzyme users. We offer two new approaches that greatly increase worker participation and also improve understanding of the production process. We also highlight limitations of traditional air sampling. The new approaches are semi-quantitative tools to detect, rank, and control sources of dust release and product spillage. Our main conclusions are that detergent enzymes can be handled safely in the workplace provided there is no visible dust or spillage. Finally, we highlight the value of prick testing as a safe, simple tool to objectively asses the effectiveness of a hygiene program and to provide an "early alert" in the event of outages in the management system.

Air Pollution, Indoor↗
PubMed2005

An evaluation of HACCP implementation status in UK small and medium enterprises in food manufacturing.

To reduce foodborne illnesses, hazard and risk-based quality management systems are essential. Small and medium sized companies (SMEs) tend to have a poor understanding of such systems and limited adoption of the Hazard Analysis Critical Control Point system (HACCP). The requirement for full HACCP implementation by 2006 will place an even greater burden on these businesses. The aim of this project is to assess the current levels of understanding of hazards and risks in SMEs in the manufacturing sector. A questionnaire survey was made of 850 SMEs, including microbusinesses. This determined the industry sector and processes carried out, whether the company operated hazard-based quality management and the knowledge of the technical manager regarding the associated hazards and risks. Follow-up visits to the manufacturing plant observed the processes and the operatives to determine their level of understanding. A benchmarking audit was carried out and each company was rated. The results show that the majority of respondents stated that they operated hazard analysis-based quality management. The ability of the respondents to correctly define a hazard or risk or identify different types of hazard was, however, poor. There was no correlation between business type and audit score. The microbusinesses did, however, perform significantly less well than the larger SMEs.

Benchmarking↗
PubMed1994

Prospective controlled evaluation of the effect of a community based asthma education centre in a multiracial working class neighbourhood.

BACKGROUND: Previous work has indicated a high rate of non-attendance at hospital based clinics among young, multiracial asthmatic patients of lower socioeconomic class. The efficacy of delivering asthma education from a community health centre established in a multiracial working class neighbourhood was evaluated. METHODS: A prospective controlled study was performed in which asthmatic subjects aged between two and 55 years attending a hospital emergency room with acute asthma and living within a defined geographical area of high emergency room users were randomised to the usual follow up or the education centre plus usual follow up. Measurements were taken at entry into the study and again nine months later. RESULTS: At nine months patients randomised to the education centre had more preventive medications, more peak expiratory flow meters and better flow meter technique, more self-management plans, better knowledge of appropriate action to take when confronted with worsening asthma, less nocturnal awakening, and better self-reported asthma control than the control group. There was no difference between the study groups in measurements of compliance, hospital admission, days lost from school or work, or emergency room use. CONCLUSIONS: The main effects of education were on asthma knowledge and self-management skills, whilst improvements in asthma morbidity were small. Potential reasons for this include heterogeneous study population (in terms of baseline self-management skills, asthma severity, ethnicity and age), pragmatic study design, insensitivity of many of the measurements of morbidity, the modest effectiveness of a single time limited education programme, and inability to limit the effects of such a large community based study to the intervention group (there was a 67% reduction in asthma admissions during the study period from the geographical area targeted compared with a 22% reduction for the rest of Auckland).

Adolescent↗
PubMed1994

Where to go to become a managed care expert.

When it comes to finding your way through the thicket of managed care options and opportunities that are springing up across the country, knowledge is power. Here's a handy reference that lists places you can turn to increase your knowledge of managed care.

Consultants↗
PubMed1995

Perceptions of management development in selected hospitals.

Today health care executives are managing organizations that are complex and require a higher degree of financial management, medical knowledge, and general business skills. The skills and academic background required to manage health care facilities have been debated by practitioners and academicians over the years. This study will examine executives' perceptions of management development activities in their organizations. To assess these perceptions, an eight-item questionnaire was mailed to 587 executives. Forty-two percent were returned. The data showed that a majority of the respondents indicated that the management development programs in their organizations were well received and that the morale of managers had improved. The pressures and challenges facing health care organizations will require managers and executives to make use of a wide range of skills if they are to be successful.

Health Services Research↗
PubMed1990

Development of a computer-aided reference system for differential diagnostics support.

In a situation of uncertain diagnosis, physicians may spend valuable time consulting relevant literature, often with unsatisfactory results. Therefore, our aim was to develop a computer system which supports differential diagnostics via rapid and comprehensive searches through information in literature. Based on entered signs and symptoms our prototype is able to offer probable diagnoses. Subsequently, further examinations and tests are suggested to confirm or exclude a certain disease. Thus, the final diagnosis is made gradually by differentiation of possible diseases. Our first attempt consisted in representing knowledge in a rule-based PROLOG system. However, because nearly all information for a sign-oriented differential diagnosis can be represented with very few relations only, we turned to a fact-oriented representation of signs and diseases. Access was possible via PROLOG or an imperative programming language. The index-sequential access on a fact-oriented representation of knowledge was suitable to manage a large knowledge base, which is necessary for a thorough differential diagnosis. A pointer structure was recently examined in order to handle different object-to-object relations. Efficient information processing is now possible which provides short response times using even broad knowledge bases.

Diagnosis, Computer-Assisted↗
PubMed2001

Impact of educational intervention on knowledge of mothers regarding home management of diarrhoea.

A pre and post comparison study was carried out in the field practice area of M.S. Ramaiah Medical College Bangalore, Karnataka to assess the impact of educational intervention on the knowledge of mothers of under five children on home management of diarrhoeal diseases. Sample of 225 mothers were included in the study. The study was conducted in 3 stages. Stage I--initial knowledge, attitude and practice of mothers was assessed. Stage II--one to one educational intervention was conducted and supported by audiovisual aids and live demonstration. Stage III--included post intervention knowledge, attitude and practice after 2 months and 2 years. After the educational intervention, there was significant improvement on knowledge of mothers regarding definition of diarrhoea (P < 0.001), signs of dehydration (P < 0.001), awareness of ORS solution (P < 0.001), correct preparation of ORS solution (P < 0.001), shelf-life of ORS solution (P < 0.001), seeking health care (P < 0.001) and rational drug therapy during diarrhoea (P < 0.001). McNemar test was used to find out the change in knowledge before and after the educational intervention. The overall knowledge scores improved significantly after 2 months (P < 0.001) as well as 2 years (P < 0.001) of the educational intervention. Though the proportion of mothers retaining the knowledge at the end of 2 years dropped, yet there was significant improvement (P < 0.001) when compared to the baseline study.

Child, Preschool↗
PubMed2001

The management of thyroid disease by GPs.

BACKGROUND: Good medical practice depends on a collaborative relationship between a GP and a targeted specialist. OBJECTIVE: The aim of the present study was to assess knowledge and management by GPs of common endocrine disorders such as thyroid diseases. METHODS: We submitted to all the GPs (622) of the Province of Lecce an anonymous questionnaire with 11 questions which aimed to evaluate methods of approach to (questions 1 and 2) and knowledge about (questions 3-11) thyroid diseases. RESULTS: (i) Most GPs (72.1%) evaluate thyroid function on the basis of a clinical suspicion and perform preliminary investigations before referring the patient to a specialist. (ii) The ratio between right and wrong answers was significantly higher for four questions, significantly lower for one question and distributed by chance for four questions. (iii) The degree of knowledge strictly corresponds to the GP's attitude to patient's management. CONCLUSIONS: For a thyropathic patient to be diagnosed rapidly and treated efficiently, it is necessary to disseminate knowledge of standardized protocols to ensure a better utilization by both the GP and the endocrinologist of their respective competences.

Chi-Square Distribution↗
PubMed2006

Physicians' perceived knowledge of and responsibility for managing patients' out-of-pocket costs for prescription drugs.

BACKGROUND: Most insurers in the US have implemented incentive-based formularies that rely on out-of-pocket costs to influence prescription drug utilization. Medicare Part D plans have broadly adopted such benefit designs. OBJECTIVE: To evaluate physicians' perceptions of their knowledge of formularies and out-of-pocket costs, factors that influence knowledge of costs, physicians' perceived responsibility for helping patients manage their out-of-pocket costs for prescription drugs, and physicians' perceptions of the role of pharmacists in managing these costs. METHODS: A multiple-choice survey was mailed to a random sample of 1200 physician members of the California Medical Association; a phone survey of nonresponders was then conducted. RESULTS: Of 1027 surveys delivered to correct addresses, 509 (49.6%) responses were received. Thirty-three percent of physicians reported that they were usually or always aware of patients' formularies and 20% were usually or always aware of patients' out-of-pocket costs for medications. Surgeons, emergency department physicians, and physicians that prescribe from more formularies than other physicians are less likely to be aware of patients' out-of-pocket costs, while physicians in large practices and those who use computers to prescribe are more aware. While 91% of physicians agreed that it is important that patients' out-of-pocket costs be managed, 40% somewhat or strongly agreed that it is their responsibility to help. Sixty-five percent of physicians believed that it is the responsibility of the pharmacist to be familiar with patients' out-of-pocket costs. CONCLUSIONS: Physicians often lack the knowledge to assist patients in the management of their out-of-pocket costs for prescription drugs and they depend on pharmacists to help patients manage those costs. Computer order entry and resources available in large physician organizations improve physicians' awareness of out-of-pocket costs when prescribing.

Attitude of Health Personnel↗
PubMed2005

A randomized controlled trial of an educational intervention on Hellenic nursing staff's knowledge and attitudes on cancer pain management.

The purpose of this randomized controlled study was to explore the effectiveness of an educational intervention on nurses' attitudes and knowledge regarding pain management and to explore associations with nurses' characteristics. A four Solomon group experimental design was employed to assess the effect of the intervention and potential effects of pre-intervention testing. One hundred and twelve nurses were randomized to two intervention and two control groups. The intervention was based on viewing a series of educational videotapes and case scenarios. The Validated Hellenic version of the Nurses Knowledge and Attitudes Survey Regarding Pain (GV-NKASRP) was used. Pre-intervention scores revealed various limitations in regard to pain assessment and management. At the pre-test, the average number of correct answers was 17.58+/-7.58 (45.1%+/-19.3% of total questions). Pre-intervention scores differed significantly among participants with different educational backgrounds (P < 0.0001). A significant effect of pain education on total knowledge scores as well as regarding specific questions was detected. Intervention group participants provided 6.11+/-5.55 additional correct answers (15.66%+/-14.23% improvement, P < 0.0001), and they exhibited significantly improved post-test scores compared to controls (26.49+/-5.24 vs. 18.75+/-4.48; P < 0.0001). A potential negative effect of pre-test on knowledge gain for specific items and for total scores was detected. These findings suggest low pre-test knowledge scores among Hellenic oncology nurses and a significant effect of the intervention.

Adult↗
PubMedDate not supplied

Management and treatment options for epilepsy.

Epilepsy is a major chronic condition of the nervous system affecting almost 380,000 people in England and occasionally results in death of the patient. Although epilepsy and its treatment are complex, there is evidence to support a significant gap in epilepsy care, ranging from a lack of adequate record keeping of seizure occurrence to poor referral systems. This article provides a broad introduction to the condition, discusses the incidence, disease process, diagnosis, classification and the various ways, both conventional and otherwise, in which it can be managed. By understanding the above, it will assist healthcare practitioners to improve their knowledge about management of a client with epilepsy entrusted to their care.

Epilepsy↗
PubMed2004

Self-management and behaviour modification in COPD .

There is new evidence from recent studies that disease-specific self-management improves health status and reduces hospital admissions in COPD patients. It is critical to implement health education programs in the continuum of care aimed at behaviour modification. Studies in COPD have shown that self-management increases knowledge and skills the patients require to treat their own illness. It is also essential to be more effective in improving patients' confidence in their ability to follow a self-care regimen, for example, by augmenting self-efficacy. Self-efficacy plays a part in determining which activities or situations an individual will perform or avoid. Results from a recent qualitative study suggested that a continuum self-management program helps COPD patients to perform given self-health behaviours. COPD patients have perceived barriers and factors (disease-related skills), which will hinder or facilitate lifestyle modification. To be successful, self-management does require a multifaceted approach that incorporates not only teaching various disease contents but also implementing strategies to change behaviour in patients. Further research is needed to develop strategies on how to intervene and facilitate behaviour modification in chronic disease and as such the relevance for the implementation of self-management programs in COPD.

Aged↗
PubMed1994

The recognition and management of melanoma and other skin lesions by general practitioners in New Zealand.

AIM: To assess current levels of knowledge and management practices with respect to melanoma and other skin cancers, in a representative sample of New Zealand general practitioners. METHODS: A self-administered questionnaire was sent to a random sample of 900 general practitioners. The questionnaire included 12 cases with coloured photographs of skin lesions and a brief presenting history. Responders were asked to assess probable diagnosis, need for biopsy and management of the lesion. Other attitudinal and relevant background information was also gathered. The questionnaire was sent to a comparison sample of 35 dermatologists. RESULTS: The overall response rate was 66% among the general practitioners and 68% among the dermatologists. The sample responding was representative of the larger population of doctors practising in New Zealand. Correct decisions whether or not to biopsy lesions (mean score of 10.1 out of 12) were significantly higher than the number of correct diagnoses (mean 8.4). Correct identification and recognition of the need to biopsy melanomas was high. Diagnostic skills and recognition of the need for biopsy were somewhat lower among general practitioners aged 50 years and over than among younger doctors. Doctors who had experience of a patient with melanoma had higher diagnostic skills and made more correct biopsy decisions. The general practitioners' scores for correct biopsy decisions were similar to those of the dermatologists sampled, although their diagnostic skills were somewhat lower, particularly with respect to nonmelanoma skin cancers. CONCLUSION: The findings indicate a high level of expertise in terms of diagnosis of skin lesions and identification of need to biopsy suspicious lesions among general practitioners in this country.

Clinical Competence↗