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PubMedDate not supplied

Reliability and validity of a risk assessment tool for patients with kidney failure.

Reliable and valid tools are needed to assist nurses to prospectively identify high-risk patients with kidney failure. Early identification of high-risk patients permits targeting of nursing interventions and resources to improve quality and cost outcomes. A 16-item risk assessment tool Risk for Outcomes Adverse to Dialysis (ROAD), was developed based on a comprehensive review of the literature on risk factors associated with adverse outcomes with kidney failure Reliability and validity of the ROAD was tested on a random sample of 253 participants in the Anemia Management Demonstration Project. High risk scores on the ROAD were significantly associated with hospitalization 1 to 6 months following risk assessment and inversely correlated with physical and mental components of quality of life. The results indicate that the ROAD provides a useful tool to identify patients on hemodialysis at risk of poor outcomes.

Activities of Daily Living↗

PubMedDate not supplied

Pilot study of a tool to investigate perceptions of family-centered care in different care settings.

BACKGROUND: Family-centered care (FCC) is widely used in pediatrics, but its applicability in all areas of pediatric care is little studied. AIMS: This study, based in Australia, aimed to develop and trial a tool to compare parents' and staff's perceptions of FCC in inpatient versus outpatient areas, hospital versus community, public (non-fee paying) versus private, areas with acute versus chronic admissions, and those with short-term versus long-term hospitalizations. METHODS: Based on two questionnaires used to examine concepts of FCC and using structured interviews and content analysis, a tool was designed that was subjected to rigorous validity and reliability testing. It was trialed with samples of 10 parents and 10 staff in each of the care areas. RESULTS AND DISCUSSION: The tool was found to effectively elicit valid responses that could be easily analyzed. Some data analysis was undertaken and significant results were found. However, because of the small sample sizes, few conclusions could be drawn.

Acute Disease↗

PubMed2004

Modeling and analyzing biomedical processes using workflow/Petri Net models and tools.

Computer simulation enables system developers to execute a model of an actual or theoretical system on a computer and analyze the execution output. We have been exploring the use of Petri Net (PN) tools to study the behavior of systems that are represented using three kinds of biomedical models: a biological workflow model used to represent biological processes, and two different computer-interpretable models of health care processes that are derived from clinical guidelines. We developed and implemented software that maps the three models into a single underlying process model (workflow), which is then converted into PNs in formats that are readable by several PN simulation and analysis tools. These analysis tools enabled us to simulate and study the behavior of two biomedical systems: a Malaria parasite invading a host cell, and patients undergoing management of chronic cough.

Algorithms↗

PubMed2004

CliniViewer: a tool for viewing electronic medical records based on natural language processing and XML.

With the evolving use of computers in healthcare, the electronic medical record (EMR) is becoming more and more popular. A tool is needed that would enable physicians to accurately and efficiently access clinical information in multiple medical records associated with a particular patient. Both natural language processing (NLP) and the eXtensible Markup Language (XML) have been used in the clinical domain for capturing, representing, and utilizing clinical information and both have shown great potential. In this paper, we demonstrate another use of XML and NLP through CliniViewer, a tool that organizes and presents the clinical information in multiple records. We also describe the flexibility and capability provided when combining XML and NLP to summarize, navigate, and conceptualize structured information. The tool has been fully implemented and tested using patients with multiple discharge summaries.

Humans↗

PubMed2004

Developing an interaction-centered evaluation tool for distance education.

Web-based distance instruction is growing in popularity. As more courses and programs go online, instructional methods and technologies are changing to meet new demands. These courses and instructional methods need be evaluated to determine their quality and to aid in their development. An instrument that measures the quality of student interaction within courses could play a useful role in this evaluation. The objective of this project was to produce an interaction-centered evaluation tool for distance education. We developed items for the evaluation tool based on a review of the literature and interviews with distance education faculty. We then conducted a measurement study to determine the instrument's validity and reliability. Fifty-five students in seven medical informatics courses participated in this study. Questionnaire items were included or rejected based on their fit with underlying theoretical constructs. In conclusion, the Web-based evaluation tool developed in this project measures student perception of quality of course interactions with demonstrated validity and reliability.

Computer-Assisted Instruction↗

PubMed2002

Validity and reliability of the Perineal Assessment Tool.

This study was conducted to evaluate the validity and reliability of an instrument designed to measure risk of perineal skin injury in hospitalized individuals. Interrater reliability of the Perineal Assessment Tool was examined by correlating the scores calculated by a wound, ostomy and continence nurse compared to those calculated by staff RNs and LPNs using the same tool with the same patient. Content validity was assessed by obtaining level of agreement ratings from 102 wound, ostomy, and continence nurses. Good correlation between the expert and staff nurse scores was found (r = .970, confidence intervals = 95%, P = .923 to .988 or P < .0001). Average perineal assessment tool subscale level of agreement scores ranged from 7.66 to 8.4 (range 1 = strongly disagree to 10 = strongly agree) and the median score for all subscales was 9. The results obtained are encouraging and justify additional reliability and validity studies.

Attitude of Health Personnel↗

PubMed2004

Application of subjective global assessment as a screening tool for malnutrition in pediatric surgical patients.

OBJECTIVES: To determine the incidence of malnutrition in the pediatric surgical ward and to evaluate the value of SGA as a nutrition assessment tool in this patient group. PATIENTS AND METHOD: Consecutive pediatric patients aged 2 months-16 years who were admitted for an operation in the pediatric surgical ward, Songklanagarind Hospital from February to September 2001 were included. Nutritional assessment was performed for each case, using a translated version of the SGA questionnaire. Anthropometric measurements and laboratory tests were performed as a routine pre-operative evaluation. The result of the SGA ratings were tested against the other parameters and Gomez's weight for age (W/A) criteria for protein energy malnutrition. SGA and the other parameters were tested for association with post-operative infectious complications. Each SGA question was analyzed by multivariate logistic regression analysis, to determine an independent correlation between the question item and final SGA rating. RESULTS: The study included 78 patients. At least one item of SGA history was positive in 28 cases (35.9%). The SGA rating was class A in 50 cases (64.1%), class B in 17 cases and class C in 11 cases. According to the Gomez classification, 42 cases (53.8%) were considered normal or overweight, whereas 23 cases (29.5%) were in the first degree underweight, 9 cases were in the second degree and 4 cases were in the third degree. Malnutrition by SGA rating correlated significantly with Gomez's second and third degree malnutrition, lower z-score, lower BMI and hypoalbuminemia. Malnutrition by SGA rating and hypoalbuminemia were associated with increased risk of an infectious complication, whereas a significant relation between a complication and anthropometric malnutrition could not be demonstrated. Moreover, SGA malnutrition was significantly associated with a longer post-operative stay. Among 5 items of SGA questions, history of weight change in the recent 2 weeks and increased energy need considered by an underlying disease were found to be independently associated with a final SGA rating of malnutrition. History of weight loss and gastrointestinal symptoms were the 2 most sensitive questions. CONCLUSIONS: SGA is a sensitive and specific nutrition assessment tool useful in a pre-operative pediatric setting. Application of the protocol as a complement of standard anthropometric tool should be considered.

Adolescent↗

PubMed2004

Odour management tools--filling the gaps.

In many countries the approach to odour management and regulation is increasingly based on quantitative techniques and criteria for acceptable exposure to odours in the living environment. A range of tools exists for implementing this approach, from emission measurement to assessment of effects. Some of these tools are well developed and validated, such as the use of olfactometry in laboratories operating according to international standards (EN13725:2003) and applying quality control and assessment systems under strict supervision by accreditation bodies. But other tools, while widely used, which are really still in the development stage, without standardisation or adequate validation. And then there are those that are still on the "wish list" of methods we would like to have in our toolbox. This paper contains a gap analysis that aims to provoke discussion on the needs for concerted R&D, standardisation and validation.

Accreditation↗

PubMed2004

Academic health sciences library Website navigation: an analysis of forty-one Websites and their navigation tools.

BACKGROUND: The analysis included forty-one academic health sciences library (HSL) Websites as captured in the first two weeks of January 2001. Home pages and persistent navigational tools (PNTs) were analyzed for layout, technology, and links, and other general site metrics were taken. METHODS: Websites were selected based on rank in the National Network of Libraries of Medicine, with regional and resource libraries given preference on the basis that these libraries are recognized as leaders in their regions and would be the most reasonable source of standards for best practice. A three-page evaluation tool was developed based on previous similar studies. All forty-one sites were evaluated in four specific areas: library general information, Website aids and tools, library services, and electronic resources. Metrics taken for electronic resources included orientation of bibliographic databases alphabetically by title or by subject area and with links to specifically named databases. RESULTS: Based on the results, a formula for determining obligatory links was developed, listing items that should appear on all academic HSL Web home pages and PNTs. CONCLUSIONS: These obligatory links demonstrate a series of best practices that may be followed in the design and construction of academic HSL Websites.

Academic Medical Centers↗

PubMed2004

Mark-up based analysis of narrative guidelines with the Stepper tool.

The Stepper tool was developed to assist a knowledge engineer in developing a computable version of narrative guidelines. The system is document-centric: it formalises the initial text in multiple user-definable steps corresponding to interactive XML transformations. In this paper, we report on experience obtained by applying the tool on a narrative guideline document addressing unstable angina pectoris. Possible role of the tool and associated methodology in developing a guideline-based application is also discussed.

Artificial Intelligence↗

PubMed2005

A vision-based surgical tool tracking approach for untethered surgery simulation and training.

This paper presents progress in the development of an untethered surgery simulation and training system. A surgical trainee interacts with the simulation in the most natural way possible-using standard, untethered surgical tools and hands. This natural interface requires innovations in tracking, haptic feedback, and visualization. This article describes the approach used for tool tracking with color cameras. A novel tracking algorithm is used to identify the type of tool, its position, and its orientation. Integration of the vision system with the tissue deformation and visualization modules is also discussed.

Algorithms↗

PubMed2005

Validation of the HITS domestic violence screening tool with males.

BACKGROUND AND OBJECTIVES: To date, screening tools for domestic violence have been validated only for use with female patients. A four-item HITS (Hurt-Insult-Threaten-Scream) screening tool is one of those instruments. The purpose of the current research was to validate the HITS screening tool in a population of male patients. METHODS: In Phase I of the study, 78 non-victim male subjects from an ambulatory clinic, a Human Immunodeficiency Virus (HIV) clinic, or emergency room completed the HITS and the Conflict Tactics Scale to establish the concurrent validity of the HITS. In Phase II, Optimal Data Analysis (ODA) was used to establish the construct validity of the HITS by identifying the score that reliably differentiated Phase I non-victims from 17 self-identified male victims of domestic violence. RESULTS: Concurrent validity of the HITS was good. ODA found that the score of 11 on the HITS differentiated between non-victims and victims. Sensitivity and specificity were 88% and 97%, respectively. Predictive values were 97% for non-victims and 88% for victims. The positive and negative likelihood ratios were 34.41 and 0.12, respectively. CONCLUSIONS: HITS differentiated between male victimized respondents from non-victims in clinical settings.

Adolescent↗

PubMed2005

Preparing to thrive during career transitions: tools for the occupational health nurse.

Whether planned or unexpected, career transition can have positive results that lead to personal growth and a more fulfilling work life. The transition period should be recognized as an opportunity to assess the past and positively shape the future. Occupational health nurses who enhance their professional and communication skills and maintain up-to-date tools are likely to have a competitive advantage during career transitions. Recommended job search tools include an up-to-date and scannable resume and a portfolio that includes summaries of key accomplishments and recognition received, business references, and a network of contacts. Networking is most effective when it is a mutual exchange. Tullier (1998) suggests individuals remember to seek opportunities to provide value to those who have provided assistance, and to become a resource to those in need of assistance. Ways to support and mentor others include sharing a current article of interest or information about an event they might wish to attend, recommending them as speakers, nominating them for awards, volunteering assistance on a special project or to a charity they support, and acknowledging and congratulating them on their accomplishments. Developing a personal action plan might include objectives such as initiating more frequent contact with individuals in one's network, developing or updating job search tools, improving speaking or writing skills, or increasing involvement in professional or community organizations. Whatever the action items identified and completed, the result will be future career transitions that are more likely to yield positive outcomes.

Career Mobility↗

PubMed1992

Case presentation as a teaching tool: making a good thing better.

Formal lectures have generally replaced case presentations as teaching tools for group learning in internship and residency programs. This article discusses two forms of case presentations--"traditional" and "chunked." Best used to convey medical information, the traditional approach proves less than optimal as a tool in teaching problem-solving skills. The "chunked" method, on the other hand, is an excellent format for formal small- and large-group instruction. An overview and suggested approach for each type is outlined herein. Properly used, each type can be a more efficient, effective tool than lectures when it comes to teaching medical problem-solving skills.

Curriculum↗

PubMed1992

Outpatient oncology chemotherapy documentation tool.

Time-saving documentation tools are vital in today's patient care environment. One such tool was designed to facilitate charting of the wide variety of information generated during outpatient chemotherapy administration. It is anticipated that this tool eventually will be incorporated as a component of a quality assurance program.

Ambulatory Care↗

PubMed2005

Development and validation of tools to assess genetic discrimination and genetically based racism.

It is possible that communication from mass media, public health or consumer advertising sources about human genetics and health may reify stereotypes of racialized social groups, perhaps cueing or exacerbating discriminatory and racist attitudes. This research used a multifaceted approach to assess lay perceptions of genetic discrimination and genetically based racism (N = 644). Two tools for use in strategic planning efforts associated with communicating about human genetics and health, the genetic discrimination instrument (GDI) and the genetically based racism instrument (GBRI), were derived. The GDI emerged as having five dimensions associated with lay perceptions of genetic discrimination. The GBRI was found to be unidimensional. Scale validation activities supported the tools' concurrent and discriminant validity characteristics. Significant differences between blacks and whites on the criminal control rights, social reproductive rights and employer rights factors as well as the GBRI were found. We recommend application of these screening tools prior to national dissemination of messages associated with genes and disease susceptibility, including school and university-based curricula.

Adult↗

PubMed2005

Portfolio as a learning tool: students' perspective.

Portfolio writing is a method of encouraging reflective learning among professionals. Although portfolio-based learning is popular among educators, not many studies have been done to determine students' perceptions of portfolio as a learning tool. A questionnaire survey was conducted among 143 medical students to find out their perceptions of the portfolio as a learning tool. A majority of the students felt that the portfolio is a good learning tool. However, they also perceived that it is stressful and time-consuming to develop a proper portfolio. The study indicates that students need appropriate guidance from the academic staff for the system to succeed.

Documentation↗

PubMed2005

New diabetes prediction tool lets patients, providers take glimpse into the future.

A diabetes risk prediction tool for providers and patients. An innovative computer model that has essentially turned anatomical processes into mathematical equations is now being used to help patients and their physicians mitigate their risk for diabetes or its complications. This is being done through an easily accessible online tool that developers maintain is far more accurate than previous risk prediction tools--and it may well be just a hint of things to come.

Diabetes Mellitus↗