Knowledge management: another avenue for HIM professionals.
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Humans↗
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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.
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Elderly pain assessment and pain management knowledge of long-term care nurses.
The purpose of this study was to determine the knowledge base of long-term care nurses regarding pain assessment and management in the elderly. Three specific themes related to long-term care nurses were investigated: personal beliefs regarding patients' self-reports of pain, documentation of patients' self-reports of pain, and choice of pain medication and dose. Eighty-nine long-term care nurses, from 6 rural counties in California, responded to a questionnaire that consisted of 2 patient scenarios. The scenarios portrayed 1 patient as smiling and showing no objective signs of pain and the other patient as grimacing. Three questions followed up the scenarios related to elder pain assessment and management. Nurses were asked to indicate their pain assessment on a 0 to 10 scale and to choose the correct pain medication and dose. Frequencies and means were used to analyze demographic data; frequencies, t tests, and chi 2 testing compared nurse responses with the different questions. Results indicated that nurses were more likely to believe and document the grimacing patient's self-report of pain than the smiling patient. Older nurses with more experience were less likely to believe or document their patient's self-report of pain than younger nurses with fewer years of experience. Less than half of the nurses would increase the analgesic dose for either patient scenario. Nursing implications include the importance of ongoing pain assessment and management education tailored to the geriatric population and long-term care.
Adult↗
Provider-sponsored virtual communities for chronic patients: improving health outcomes through organizational patient-centred knowledge management.
Patients with long-term chronic disease experience numerous illness patterns and disease trends over time, resulting in different sets of knowledge needs than patients who intermittently seek medical care for acute or short-term problems. Health-care organizations can promote knowledge creation and utilization by chronic patients through the introduction of a virtual, private, disease-specific patient community. This virtual socialization alters the role of chronic disease patients from external consumers of health-care services to a 'community of practice' of internal customers so that, with the tacit support of their health-care organization, they have a forum supporting the integration of knowledge gained from the experiences of living with chronic disease in their self-management. Patient-centred health-care organizations can employ the virtual community to direct and support the empowerment of chronic patients in their care.
Chronic Disease↗
[Obesity management knowledge, attitudes and practices of general practitioners in southeastern France; results of a telephone survey].
OBJECTIVE: To describe the current knowledge, attitudes, and practices of French general practitioners (GPs) in the field of child and adult overweight and obesity management. METHODS: A cross-sectional telephone survey interviewed a sample of 600 GPs, representative of the population of private GPs in southeastern France. A three-part questionnaire assessed attitudes and opinions about overweight and obesity, knowledge and training in this field, and practices (diagnostic methods, standard weight loss objectives, types of counseling). RESULTS: Most GPs (90.2%) regarded obesity as a disease requiring long-term management (99.5%), and 79% agreed that managing these problems is part of their role. Nevertheless, 58 and 66% did not feel they perform this role effectively for their adult patients and for children and teenagers, respectively. Approximately 30% had negative attitudes towards overweight and obese patients. Most practices followed the guidelines relatively closely. Nevertheless, 60% often set weight loss objectives more demanding than guidelines call for; neither food diaries nor nutritional education were used systematically; 55% often forbade children and teenagers to eat specific foods. DISCUSSION: These results, which were based on GPs' declarations, revealed the existence of a gap between theory and practice in the field of obesity management: GPs felt responsible for but ineffective in this management. Their feelings of ineffectiveness may be furthered by the underlying disagreement in the attitudes of practitioner and patient towards weight problems and the ensuing difficulties in their relationship.
Adult↗
Decision support and knowledge management in oncology using hierarchical classification.
This paper presents the KASIMIR research project for the management of decision protocols in oncology. A decision protocol is a kind of decision tree implemented in an object-based representation formalism. A reasoner based on such a formalism and on hierarchical classification is coupled with a knowledge editor. This association provides an assistance for editing and maintenance of protocols, enabling the detection of errors and the comparison between versions of the protocol. In this way, a management of protocols takes fully advantage of the underlying knowledge representation and reasoning tools. This straightforward use of the protocol may be insufficient in some situations. Then, the protocol may have to be adapted for these situations. A study of protocol adaptation is presented. In particular a reasoner based on a combination of hierarchical classification and fuzzy logic is introduced.
Algorithms↗
Neonatal jaundice and its management: knowledge, attitude and practice of community health workers in Nigeria.
BACKGROUND: Neonatal jaundice (NNJ) is still a leading cause of preventable brain damage, physical and mental handicap, and early death among infants in many communities. Greater awareness is needed among all health workers. The objective of the study was to assess the knowledge of primary health care workers about the description, causes, effective treatment, and sequelae of NNJ. METHODS: The setting was a local government area i.e. an administrative district within the south-western part of Nigeria. Community health workers in this area were interviewed by means of a self-administered questionnaire which focused on awareness and knowledge of neonatal jaundice and its causes, treatment and complications. RESULTS: Sixty-six community health workers participated in the survey and male-to-female ratio was 1:5. Their work experience averaged 13.5 (SD 12.7) years. Only 51.5% of the respondents gave a correct definition of NNJ. 75.8 % knew how to examine for this condition while 84.9 % knew at least two of its major causes in our environment. Also, only 54.5 % had adequate knowledge of effective treatment namely, phototherapy and exchange blood transfusion. Rather than referring affected babies to hospitals for proper management, 13.4 %, 10.4 % and 3 % of the participants would treat with ineffective drugs, natural phototherapy and herbal remedies respectively. None of the participants knew any effective means of prevention. CONCLUSION: Primary health care workers may have inadequate knowledge and misconceptions on NNJ which must be addressed concertedly before the impact of the condition on child health and well-being can be significantly reduced. We recommend regular training workshops and seminars for this purpose.
Adult↗
Medical data and knowledge management by integrated medical workstations: summary and recommendations.
The health care professional workstation will function as an interface between the user and the patient data as well as an interface pertinent medical knowledge. Appropriate knowledge focus will require the workstation to recognize the concepts and structure of patient data, and understand the scope and access methods of knowledge sources. Issues are organized around five major themes: (i) structure, (ii) reliability and validation, (iii) views, (iv) location, and (v) ethical and legal. Conventional database representations can effectively address data structure and format variations that will inevitably persist in local data stores. The reliability of data and the validation of knowledge are critical issues that may determine the ultimate utility of clinical workstations. Alternative views of patient information and knowledge sources represent the true power of an intelligent data portal, represented by a well-designed clinical workstation. Both data and knowledge are optimally represented in decentralized information networks, although the confidentiality and ownership of this information must be respected. Evolutionary progress toward consistent representations of knowledge and patient data will be facilitated by the establishment of self-documentation standards for the developers of data encoding systems and knowledge sources, perhaps extended from the preliminary model afforded by the Unified Medical Language System (UMLS).
Computer Security↗
Knowledge management prerequisites for building an information society in healthcare.
The European Research Area requires either technological development or information literacy of health professionals. This information literacy shall be understood much deeper and broader than a basic preparation to use ICT tools in everyday life only. The author's first aim is to present the literature review and analysis of different definition of the "information" concept in Polish and foreign sources for health sciences, to emphasize a problem fundamental for an information society development, i.e. lack of adequate "information" understanding. Health professionals' information literacy shall also build an awareness of conceptual differences among numerous classifications, thesauruses, and information-retrieval languages, which result in different information received in a retrieval process. This problem can be of crucial effect for either health research or practice. Understanding the problem shall mobilize the researchers, classifiers, and indexers to co-ordinate efforts aimed in organizing "a translator" covering the most popular classifications' and thesauruses' concepts, to make an international research co-operation easier, relevant, and safe for the patients.
Artificial Intelligence↗
Assessment of the continued supervision and asthma management knowledge of patients possessing home nebulizers.
This paper describes the results of a questionnaire survey on some aspects of nebulizer use, nebulizer instruction, and features relating to the recognition and management of deteriorating asthma. The study population consisted of 90 children with home nebulizers attending a paediatric asthma clinic, and 200 asthmatic children and 200 asthmatic adults whose nebulizers had been purchased directly from a manufacturer in the U.K. The results suggest that follow-up supervision of the patients who bought their own nebulizers occurred in only approximately 25% of cases. Written information focusing on the management of symptoms was also lacking. Peak flow meters were being under-used. Although the majority (77-100%) of patients were aware of the '4 h rule' for repeat use of bronchodilator therapy at home, there was still some confusion about the acceptable time interval and action to be taken should the dose be required more frequently. Very few (32%) in the nationwide adult group had a crisis action plan should the nebulizer fail to produce relief. This paper recommends that a simple treatment and crisis plan should be included with the purchased nebulizer, highlighting the key areas to be discussed by the patients with the doctor or other medical professionals. Such a package may prevent the occasional disaster that can occur with unsupervised nebulized bronchodilator usage.
Acute Disease↗
Professional development. Time management: knowledge for practice (continuing education credit).
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Education, Nursing, Continuing↗
A semantically enabled formalism for the knowledge management of Parkinson's disease.
Bio-ontology is a formal representation of biological concepts that is used in the interchange of communication between computers and humans alike. They can then be used in the formulation and retrieval of knowledge. In developing a knowledge-based system for Parkinson's Disease, a procedure of knowledge map was used to capture and harness the intellectual resources of an organization, and new paradigms for knowledge mapping were also formulated. Knowledge bases for symptoms and drugs, physiotherapy, speech and language therapy, and dieting that affect patient care were developed. Finally, the knowledge bases were merged to form a single central repository of knowledge base.
Diet↗
A knowledge management system for new drug submission by pharma-industries.
The pharma-industries are facing a number of crucial business issues to improve operational excellence in product time-to-market and wide regulatory compliance. These organizations own, produce, and manipulate a lot of knowledge. The new regulations by Health Authorities (HA) to pharma-industries should make the content and format of new drug application uniform worldwide. In this paper we suggest a novel approach of a pharma-industry to capture, process, and transmit clinical data electronically. The approach begins with an analysis of the knowledge generation points, some of them being outside the company. Implementations are grounded on the use of a de facto standard platform being Microsoft, having acceptable cost levels. The proposed infrastructure is integrated into existing company environment and technological platform, minimizing cost and risks, but improving efficiency and efficacy of new drug dossier compilation.
Drug Approval↗
Integrating information management knowledge and skills in the pre-clinical curriculum.
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Clinical Competence↗
Managing knowledge integration in a national health-care crisis: lessons learned from combating SARS in Singapore.
The outbreak of Severe Acute Respiratory Syndrome is the first severe and readily transmissible disease to emerge in the 21st century. Often one new infection meant tracing of several people to monitor their health conditions as well. In Singapore, several agencies coordinated their efforts to quickly bring the outbreak under control. The current breed of health-care information systems (HCIS) was not sufficient to handle new information-sharing needs during the crisis. In this paper, we take a look at the measures taken during the crisis in Singapore through a knowledge integration perspective. This perspective reveals interesting implications for HCIS.
Artificial Intelligence↗
Clinical knowledge management using computerized patient record systems: is the current infrastructure adequate?
The proliferation of technology in health care, spurred by environmental factors encouraging the adoption of computerized patient records (CPRs), has led to a widely held perception of fully computerized patient information systems as the industry norm. To test the validity of this assumption, using data from a national survey of certified health information managers, we examined the CPR technology adoption rates reported by health information managers, assessing variation across practice settings, regions, and organizational types. Results show that significant nonadoption, and regional variation, exists in the implementation of CPRs. Overall, nonuniform diffusion of computerized health information technology was found, despite national mandates that promote and at times require uniform adoption. A significantly greater number of hospital-based patient records were computerized, compared to clinics and other practice settings. Managers were frequently found to maintain duplicate CPRs and paper-based patient record systems, even after the initial implementation period. Nonuniform regional CPR adoption and redundant paper-based systems were found to be a common practice in medical systems, due in part to cultural factors, mistrust of computerized data, and lack of technology training and knowledge.
Delivery of Health Care↗
Knowledge management: moving the care model from a "snapshot" to a "story".
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Continuity of Patient Care↗
[Knowledge management in rehabilitation--proposal for a systematic development of clinical practice guidelines].
In the past ten years, the German pension scheme has launched several initiatives that can be regarded as milestones on the way to a scientifically founded rehabilitation system. These initiatives were: the Rehab Commission (1989 - 1991), the Quality Assurance Programme (since 1994), and the German Research Funding Programme "Rehabilitation Sciences" (in cooperation with the Federal Ministry for Education and Research, since 1996). As a next step on this way, we propose an initiative aiming at a systematic development and implementation of clinical practice guidelines for the main diagnostic groups in rehabilitation. Guidelines for diagnostic and therapeutic decisions are an instrument to sift through the abundance of fast changing knowledge in medicine, to assess the existing knowledge according to its scientific evidence, and to transform it into recommendations for clinical practice. In rehabilitation, guidelines seem to be particularly needed because specialized knowledge is mostly disseminated through an informal "training on the job". Our proposal intends to establish a reference centre for each of the main indications (cardiology, musculoskeletal diseases, etc.). These centres should cooperate with experts from clinical practice and research, as well as with representatives of the cost-carrying agencies and patient organisations, and should systematically analyse the processes of rehabilitation in the most important diagnostic groups. Guided by a "process matrix of rehabilitation", these analyses should identify the points at which far-reaching decisions are called for during the processes of rehabilitation. At these points, the knowledge base available for rational decisions should be examined. When there is no sufficient scientific knowledge, consensus conferences should be organized in order to collect and assess the available expertise of practitioners and to establish guidelines for clinical practice. Since compliance with such guidelines could be easily checked in the routine quality assurance programme, this proposal seems to be a promising way of improving the knowledge base in rehabilitation in a rather short time.
Diagnosis-Related Groups↗
Conceptual framework of knowledge management for ethical decision-making support in neonatal intensive care.
This research is built on the belief that artificial intelligence estimations need to be integrated into clinical social context to create value for health-care decisions. In sophisticated neonatal intensive care units (NICUs), decisions to continue or discontinue aggressive treatment are an integral part of clinical practice. High-quality evidence supports clinical decision-making, and a decision-aid tool based on specific outcome information for individual NICU patients will provide significant support for parents and caregivers in making difficult "ethical" treatment decisions. In our approach, information on a newborn patient's likely outcomes is integrated with the physician's interpretation and parents' perspectives into codified knowledge. Context-sensitive content adaptation delivers personalized and customized information to a variety of users, from physicians to parents. The system provides structuralized knowledge translation and exchange between all participants in the decision, facilitating collaborative decision-making that involves parents at every stage on whether to initiate, continue, limit, or terminate intensive care for their infant.
Artificial Intelligence↗