ABSTRACT
Both frequent reason for consultation and cause of absence at work, low back pain is a notorious public health concern. The Belgian Health Care Knowledge Centre (KCE) has been surrounded by 31 clinicians from different disciplines to develop a guideline covering the entire management of low back and radicular pain. A recently published guideline of the British National Institute for Health and Care Excellence (NICE) was largely used as a starting point and adapted to the Belgian context.
A la fois motif de consultation et cause d'absence au travail très fréquents, les lombalgies sont un enjeu de santé publique notoire. Le Centre fédéral d'Expertise des Soins de Santé (KCE) s'est entouré de 31 cliniciens de différentes disciplines pour élaborer un guide de pratique clinique couvrant l'entièreté de la prise en charge des douleurs lombaires et radiculaires. Ce guide se base sur le tout récent «guideline¼ britannique du National Institute for Health and Care Excellence (NICE) dont chaque recommandation a été adaptée au contexte belge.
Subject(s)
Low Back Pain/therapy , Radiculopathy/therapy , Humans , Low Back Pain/etiology , Radiculopathy/etiologyABSTRACT
OBJECTIVES: To evaluate a semi-automatic data extraction from the electronic medical record (EMR) of general practitioners (GPs) through a comparison with a paper sheets data collection simultaneously used in a primary care research project on the quality of prescribing for osteoarthritis in the elderly. SUBJECTS: One hundred and fifty-two GPs using five different EMR-software systems participated with the semi-automatic data extraction from the EMR and 233 GPs collected data with paper registration sheets. METHODS: The proportion of patients with respectively a drug prescription, paracetamol, a non-steroidal anti-inflammatory drug (NSAID) and ibuprofen were compared between the semi-automatic extraction and the paper data collection and among the EMR-software systems. RESULTS: Using the semi-automatic data extraction, a significantly lower proportion of patients on drugs was obtained compared to the paper data collection (adjusted OR: 0.31; 95% CI 0.25-0.39). However, the proportion of patients on a specific type of drug was comparable. Within the results from the semi-automatic extraction, the results were heterogeneous among the different EMR-software systems. CONCLUSIONS: The semi-automatic data extraction with multiple EMR-software systems proposed in this study seems suitable for quality of prescribing assessment in primary care. However, it may be less reliable when only a single EMR-software is used.
Subject(s)
Drug Prescriptions , Medical Records Systems, Computerized , Physicians, Family , Practice Patterns, Physicians' , Quality of Health Care , Aged , Aged, 80 and over , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Belgium , Data Collection/methods , Female , Humans , Male , Medical Audit , Middle Aged , Osteoarthritis/drug therapyABSTRACT
OBJECTIVES: To identify the various sources of noise in a neonatal intensive care unit in a university hospital centre and to assess the noise level. METHODS: The nursing staff was interviewed to obtain a qualitative assessment of the noise in the department. Quantitative observations using a sound level meter and a dosimeter were then made. The measurements presented here were carried out in two different units caring for the newborn: on the heated table and in an incubator. RESULTS: Many sources of noise were identified in the unit. They were responsible for a noisy environment, the level of which was far greater than current recommendations and left few periods of quiet. The alarms of the various monitors and maintenance apparatuses, the crying of the newborn and the activity of the staff were the principal sources of noise. CONCLUSION: The impact of hospital staff on the extent and frequency of sources of noise is crucial. An enhanced awareness strategy should therefore be developed.
Subject(s)
Environment , Intensive Care Units, Neonatal/organization & administration , Neonatology , Noise/adverse effects , Personnel, Hospital , Crying , Guidelines as Topic/standards , Hospitals, Pediatric , Humans , Infant, Newborn , Intensive Care Units, Neonatal/standards , NursesABSTRACT
The paper describes the experiences with a Belgian Primary Care data Network from 1999 till 2002. Three cycles of data collection have been performed. The network involves about 300 general practitioners (GPs) and up to 8 different software packages. This network is semi-anonymous, semi-automatic and mixed (paper and electronic with various software's). For the coming next years, efforts should be focused on solving some frequently occurring problems with the data collection through the EPR, such as a considerable number of data lacking and the fact that GPs do not always use the problem oriented structure of the EPR (Electronic Patient Record). Afterwards, more promising usage could be considered and developed such as repeated data collection using a same GPs' sample, long-term recording studies, usage of larger GPs' samples, etc.
