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PubMed2006

Opportunities and obstacles in electronic data collection in nursing.

The article deals with the advantages and drawbacks of electronic data collection in nursing. The first part underlines the importance of data standards and common terminology, and traces the evolution of nursing informatics over the past decades. The main national and international projects in this field are listed. The second part describes the role of the government in promoting electronic collection of data on nursing care. In the third part, the information technology required for electronic collection of data is presented, and the current situation in Slovenia in this field is outlined. In the final part, the author suggests steps to be taken in order to achieve the final goal: an electronic nursing record in Slovenia.

Data Collection↗
PubMed2006

[Ethicolegal issues of organ donation as the main obstacle to the progress of clinical transplantation].

Ethicolegal issues present the main factor hindering obtaining organs from corpses and living donors, the distribution of cadaveric organs, and the financial providence of donorship in Russia. The actual Russian legislation is contradictory in terms of obtaining relatives' consent for the transplantation of cadaveric organs. There are no precise definitions of the degree of genetic relationship between the donor and recipient sufficient for transplantation. Selling and purchasing human organs is strictly prohibited, while financial compensation of the living donor seems to be a fair measure. Providing the possibility to verify brain death is a necessary condition for expanding the cadaveric organ pool. The organ shortage leads to improper distribution of donor organs. All these problems have to be solved for the progress of organ transplantation in Russia.

Ethics, Medical↗
PubMed1998

Hepatitis B vaccination rates among medical personnel at Ain Shams University Hospital and obstacles to vaccine uptake.

The current study included 1426 medical personnel working at Ain Shams University hospitals selected randomly; 354 staff members, 679 junior doctors (residents and internships) and 393 nurses. The overall vaccination coverage with at least one dose of HB vaccine was 40.6%. The overall coverage with 3 doses of HB vaccine was 29.1%. The mean number of working years was higher among the vaccinated group. More than 55% of personnel who had direct exposure or contact with blood were not vaccinated. HB vaccine uptake was conducted at the work place by 65.6% of vaccinated personnel and about 50% received the vaccine recently, i.e. less than one year. The side effects experienced by vaccinated subjects were local pain (5.4%) and headache (0.7%). About 38% of included personnel were not sure about the effectiveness of HB vaccine, and 47% do not know exactly the duration of vaccine validity. The current price of the vaccine was unaffordable as stated by 60.9% of subjects and 95.2% concluded that the vaccine should be funded. It was recommended that the work place is the best place for HB vaccine uptake by 80.9% of subjects and the vaccine should be obligatory for all medical personnel by 84.3% of subjects.

Attitude of Health Personnel↗
PubMed1991

Identifying, evaluating and quantifying adverse drug reactions in children: opportunities and obstacles for the manufacturer.

The monitoring of the safety of its marketed products is a recognized responsibility of the pharmaceutical manufacturer. He has the advantage to concentrate efforts on a relatively small number of compounds and to include a large number of sources and methods. Drug monitoring is especially crucial for the vulnerable groups of patients (children, pregnant women, mentally incompetent and elderly) for whom adequate controlled clinical trials are often lacking with the notable exception of pediatric oncology and vaccinations. The surveillance of adverse drug reactions (ADR) in children represents a special challenge, because of the limited opportunity for usual post marketing surveillance studies. There is a surprising scarcity of epidemiologic projects on ADRs and even of drug usage data in younger age groups. Spontaneous reports are therefore still of great importance. Because of the development of national ADR reporting systems and concomitant regulations and guidelines direct reports to manufacturers account today in the Western world only about 50 percent of the accessible reports, 40% are addressed to national authorities and with only limited access to the manufacturer, sometime even information on age and sex is not provided. The proportion of these reports is increasing and it is important that a better exchange of information can be developed. Reports in the literature account today for about 10 percent of the ADR case reports. Spontaneous reports provide early signals, they can, however, not quantify a risk and need validation. Traditional investigations are often too onerous and time consuming. A promising approach has developed on the basis of computerized health insurance data that enable record linkage of prescriptions and subsequent health events.(ABSTRACT TRUNCATED AT 250 WORDS)

Adverse Drug Reaction Reporting Systems↗
PubMed1991

[Rubber dam: how to take the obstacle].

In this article the rationale for the use of rubber dam during root-canal treatment is discussed. Illustrated by some clinical examples it is stated that almost every tooth can be adequately and efficiently isolated by means of the rubber dam technique.

Humans↗
PubMed1991

Home health care: surmounting the obstacles to Medicare coverage.

The very words that physicians use when ordering home health services for their patients may determine whether those services will be reimbursed under the Medicare benefit. Thus, it is crucial for all physicians to become aware of: 1) methods of assessing patient home care needs based on the underlying medical conditions; 2) Medicare eligibility criteria and expanded coverage now available since the Health Care Financing Administration (HCFA) coverage manual was rewritten in 1989; and 3) how to advocate to ensure that the patient receives the care to which he or she is entitled.

Aftercare↗