Search results for " Appropriateness"

Role of out of hours primary care service in limiting inappropriate access to emergency department

2017

Out of hours (OOH) doctors can have an important gate-keeping role over the access to the emergency department (ED), but the outcome and the quality of their ED referrals have been poorly studied. We aimed to investigate the outcome of patients referred to ED from OOH service and the determinants of admission or short-stay dispositions. We collected retrospectively data about referrals to ED from a local OOH service in the north-east of Italy using the OOH paper register and the ED electronic database, over the period of 01/10/2012 to 31/03/2013. Out of 5217 patients accessing the OOH service, 408 referrals were included in our analysis. 45.3% (185) of the referrals were admitted to hospita…

A multicenter study on the appropriateness of hospitalization in obstetric wards: application of Obstetric Appropriateness Evaluation Protocol (Obste…

2015

The cross-sectional study has been based on the implementation of the Obstetric Appropriateness Evaluation Protocol (OAEP) in seven hospitals to determine inappropriate hospital admissions and days of stay. The outcomes were: inappropriateness of admission and "percentage of inappropriateness" for one hospitalization. A total number of 2196 clinical records were reviewed. The mean percentage of inappropriateness for hospitalization was 22%. The percentage of inappropriateness for the first 10 d of hospitalization peaked in correspondence of the fourth (42%). The logistic regression model on inappropriated admission reported that emergency admission was a protective factor (OR = 0.4) and to …

Dentistry and Drug Adverse Events: Between Responsibilities and Regulations

2022

The purpose of this paper is to renew interest and attention to the medical history, prescription, and/or use of drugs during dental practice. The work analyzes the issue of the use of drugs in dentistry from both a clinical and a medical–legal point of view. The laws governing the matter were also taken into consideration, relating them to the roles of prescriber and user that the dentist can acquire. Analysis of various aspects of this matter demonstrates that it is necessary for dentists to know the drugs and medical substances, their characteristics and properties, related effects, and interactions in order to use them appropriately and adequately. Knowledge of interferences, reac…

Proceedings of the Closed Round Table and Italian Consensus on Clinical Appropriateness in Oral Medicine and Oral Surgery – Part I

2019

Prevalence and appropriateness of drug prescriptions for peptic ulcer and gastro-esophageal reflux disease in a cohort of hospitalized elderly

2011

Abstract Background Proton pump inhibitors (PPI) are among the most commonly prescribed medicines and their overuse is widespread in both primary and secondary care. Inappropriate prescription is of particular concern among elderly patients, who have often multiple comorbidities and need many drugs. Methods We evaluate the appropriateness of drugs for peptic ulcer or gastro-esophageal reflux disease (GERD) in a sample of elderly patients (65 years old or older) at admission and discharge in 38 internal medicine wards between January 2008 and December 2008, according to the presence of specific conditions or gastro-toxic drug combinations. Results Among 1155 patients eligible for the analysi…

Determinants of inappropriate hospitalization in cataract surgery in the south of Italy: a retrospective study

2017

Purpose To analyze the frequency of inappropriate hospitalization in cataract surgery and the type of related determinants. Methods A nested retrospective case–control study was carried out on 2708 consecutive cataract surgery patients operated between January 2013 and Decem- ber 2015. All cases with inappropriate hospitalization (day surgery or ordinary hospitalization) were com- pared with a control group of cases treated in an appropriate (day service) regimen. The predictive value for inappropriate admissions to the hospital was assessed using a logistic regression model. Significant variables from the univariate analysis were included in a multivariate model. Results Forty-five cases (…

Deliveries by caesarean sections on request of women: legal-medical evidence

2014

Introduction: In Italy the use of caesarean delivery has a rising trend moving away from European standards appeared on Euro-Peristat on maternal and child health, presenting the highest percentage of use of this procedure with significant regional differences. This study have analyzed the most recent data of a Sicilian reality about normal delivery and caesarean sections carried out in a hospital situated in Messina (Italy). Materials and methods: A total number of 1,573 medical records from 1st January 2011 to 31st December 2013 were analyzed and data gathered were statistically examined to describe general and specific parameters of the sample making use of Epi Info 7.1.4 software (CDC A…

Between a rock and a hard place : middle managers' ethical decision making and behaviour in the organisational context

2018

This study increases knowledge and understanding of middle managers’ ethical decision-making and behaviour within the context of Finnish higher education. The aim of the research is to develop a new framework for ethical decision-making and behaviour by combining prior theories and empirical knowledge. This dissertation consists of an introductory essay and three articles. The main argument of this research is that through organisations’ socialisation processes, middle managers adopt socially defined managerial roles, which affect their ethical decision-making and ethical conduct. We can say that especially the ethical organisational culture is significant for middle managers’ understanding…

THE ROLE OF THE CLINICAL PHARMACIST IN THE MANAGEMENT OF ANTIRETROVIRAL THERAPY

2020

Over the last few years, the Hospital Pharmacy has developed in an excellent way in Europe, proposing in many countries the clinical pharmacist as a new professional figure, and adapting its responsibilities to national health systems. The purpose of this study is to evaluate and promote the prescriptive appropriateness through the close collaboration between the pharmacist and the medical team. The aspect of the dispensation of antiretroviral therapy was deepened by providing useful information to the patient on the possible undesired effects and interactions due to the polypharmacy, on the correct way of storing the drugs, and on the importance of the regularity of the polypharmacy intake…