Perceived Management of Acute Sports Injuries and Medical Conditions by Athletic Trainers and Physical Therapists.

BACKGROUND: While Athletic Trainers' (ATs) education emphasizes sport event coverage, Physical Therapists' (PTs) education may prepare them for event coverage responsibilities. The objectives of this study were to compare the perceived preparedness and decision-making related to acute injury/medical condition management among ATs and PTs and evaluate the relationship between perceived preparedness and decision-making. HYPOTHESIS: ATs would report greater perceived preparedness and appropriate decision-making related to acute injury/medical conditions compared to PTs. STUDY DESIGN: Cross-sectional, Online survey. METHODS: An electronic survey was disseminated to licensed ATs (n=2,790) and PTs (n=10,207). Survey questions focused on perceived preparedness for management of acute injuries/medical conditions. Respondents also completed questions that assessed clinical decision-making related to acute injury case scenarios. Kruskal-Wallis H-Tests and Spearman's Rho Correlations were used for the analysis. Significance was set to p<0.003 after adjustment for family-wise error. RESULTS: Six-hundred and fifty-five respondents (292 ATs, 317 PTs, 46 dual credentialed PT/ATs) completed the entire survey. ATs had the highest level of perceived preparedness of all the groups (p<0.0003). Greater than 75% of PTs responded either "appropriately" or "overly cautious" to 10 of the 17 case scenarios, as opposed to 11 of the 17 case scenarios by ATs. Greater than 75% of the PTs who were board specialty certified in sports responded either "appropriately" or "overly cautious" to 13 case scenarios. CONCLUSION: More ATs than PTs perceived themselves to be prepared to manage acute injuries/ medical conditions. Further, results indicate that PTs may be an effective and safe provider of event coverage. Conditions/injuries with low perceived preparedness or poor performance may offer both ATs and PTs an opportunity to identify areas for future training and education to optimize care for athletes with acute injuries or medical conditions. LEVEL OF EVIDENCE: Level 3b.

Access and Disclosure of Personal Health Information: A Challenging Privacy Landscape in 2016-2018.

OBJECTIVES: To assess the current health data access and disclosure environment for potential privacy-protecting mechanisms that enable legitimate use of personal health information while preserving the rights of individuals. To identify the gaps and challenges between increasing requests and expanding uses of such information and the regulations, technologies, and management practices that permit appropriate access and disclosure while guarding against harmful misuse of such information. METHODS: A scoping literature review focused on (1) regulations affecting access and disclosure of personal health information, (2) the uses of health information that challenge access and disclosure boundaries, and (3) privacy management practices that may help mitigate gaps in protecting patient privacy. RESULTS: Countries and jurisdictions are developing laws, regulations, and public policies to balance the privacy rights of individuals and the unprecedented opportunities to advance health and health care through expanded uses of health data. Regulations and guidance are evolving, but they are outpaced by the increasing demand for and the challenges of managing access and disclosure. Mechanisms such as consent and authorization may not always be adequate. Mechanisms that advance principled stewardship are more important than ever. CONCLUSIONS: Access and disclosure management are important dimensions of privacy management practices. This is a volatile period in which diverging public policies may reveal how best to balance access and disclosure of personal health information by individuals and by institutional custodians of the information. Approaches to access and disclosure management, including the roles of individuals, should be a focus for research and study in the years ahead.

Safe Practice Recommendations for the Use of Copy-Forward with Nursing Flow Sheets in Hospital Settings.

BACKGROUND: In early 2016 the Partnership for Health IT Patient Safety released safe practice recommendations for the use of copy-paste for electronic health record (EHR) documentation. These recommendations do not directly address nurses' use of copy-forward to document patient assessments in flow sheet software in hospital settings. Similar to clinicians' use of copy-paste and copy-forward with progress notes, concerns exist about patient safety issues from the use of potential inaccurate or outdated information to achieve increased efficiency of documentation. METHODS: A multiple-methods approach-which included a literature review, litigation search, stakeholder analysis, and consensus opinion from experts from multiple disciplines-was employed. RESULTS: Four recommendations correspond closely with copy-paste guidance for EHR documentation from the Partnership: (1) Provide a mechanism to make copied-forward content easily identifiable, (2) Ensure that the provenance of copied-forward content is readily available, (3) Ensure adequate staff training and education regarding the appropriate and safe use of copy-forward in flow sheet software, if available, and (4) Ensure that copy-forward practices are regularly monitored, measured, and assessed. A fifth additional recommendation is made to improve the efficiency of data entry mechanisms, which may reduce patient safety risk. Emerging promising areas for innovation are to optimize interface usability and flow sheet content, use templates, use digital photographs, and eliminate work-flow steps with better methods for authentication and data entry. CONCLUSIONS: A thoughtful and measured approach to safe use of copy-forward in flow sheets by nurses in hospital settings is expected to result in improvements in efficiency of documentation, work flow, and accuracy of information.

Patient satisfaction: how do qualitative comments relate to quantitative scores on a satisfaction survey?

OBJECTIVE: This study was designed to determine whether there are differences in how patients quantitatively rate their inpatient service in a given section of a patient satisfaction survey based on the types of qualitative comments they make about that given section. METHODS: The population under study was patients discharged from The James Cancer Hospital and Solove Research Institute at Ohio State University from April 1 to June 30, 2006. A sample of 1468 questionnaires was mailed. A total of 446 completed questionnaires were returned for a response rate of 30%, and 1068 comments were offered by the respondents. RESULTS: An analysis of variance determined statistically significant differences between the ratings and the comment types in all 10 sections of the survey. A Bonferroni post hoc test revealed that the scale ratings were higher for patients who made positive comments than for patients who made negative comments for 8 of the 10 survey sections. A positive comment produced a higher mean score than did a negative comment. CONCLUSION: The study results offer empirical evidence that there are differences in how patients quantitatively rate the services received in a hospital based on patient comment types. Hospital staff interpreting patient satisfaction survey results could say that negative comments produce lower quantitative ratings than do positive comments.

Storage media profiles and health record retention practice patterns in acute care hospitals.

This exploratory study examined the health record retention practices among health information management professionals in acute care general hospitals in the United States. A descriptive research design was used, and data were collected using a self-reporting survey. Respondents answered questions about the relationship between researcher-assigned storage media profiles (descriptions of the type or types of media on which facilities maintain health records); retention periods and factors affecting record retention periods; retention of secondary data; vendor usage; and continued reliance on paper in environments where electronic health records exist. Storage media profiles were found to be significantly related to facility operational and research needs and to the convenience of not purging records. These findings have implications for federal policy promoting the implementation of electronic health records by 2014.

Record retention practices among the nation's "most wired" hospitals.

This exploratory study examined health record retention practices among health information management professionals in acute care general hospitals in the United States. A descriptive research design was used, and data were collected using a self-reporting survey. Respondents answered questions about record retention policies, the responsibility of health information professionals in policy administration, record retention periods, factors that determine retention periods, and other information about health record retention practices.