Background Iatrogenic hypoglycemia is a common occurrence among hospitalized patients and is associated with poor clinical outcomes and increased mortality. Clinical decision support systems can be used to reduce the incidence of this potentially avoidable adverse event. Objective This study aims to determine the desired features and functionality of a real-time informatics alert to prevent iatrogenic hypoglycemia in a hospital setting. Methods Using the Agency for Healthcare Research and Quality Five Rights of Effective Clinical Decision Support Framework, we conducted a mixed methods study using an electronic survey and focus group sessions of hospital-based providers. The goal was to elicit stakeholder input to inform the future development of a real-time informatics alert to target iatrogenic hypoglycemia. In addition to perceptions about the importance of the problem and existing barriers, we sought input regarding the content, format, channel, timing, and recipient for the alert (ie, the Five Rights). Thematic analysis of focus group sessions was conducted using deductive and inductive approaches. Results A 21-item electronic survey was completed by 102 inpatient-based providers, followed by 2 focus group sessions (6 providers per session). Respondents universally agreed or strongly agreed that inpatient iatrogenic hypoglycemia is an important problem that can be addressed with an informatics alert. Stakeholders expressed a preference for an alert that is nonintrusive, accurate, communicated in near real time to the ordering provider, and provides actionable treatment recommendations. Several electronic medical record tools, including alert indicators in the patient header, glucose management report, and laboratory results section, were deemed acceptable formats for consideration. Concerns regarding alert fatigue were prevalent among both survey respondents and focus group participants. Conclusions The design preferences identified in this study will provide the framework needed for an informatics team to develop a prototype alert for pilot testing and evaluation. This alert will help meet the needs of hospital-based clinicians caring for patients with diabetes who are at a high risk of treatment-related hypoglycemia.

Background: Lower Back Pain (LBP) is a common complaint among nurses in different clinical sittings. There is a large amount of evidence suggesting an association between LBP and various factors. This complaint has serious implications for professional and occupational carriers as well as whole health care systems as nurses form the mainstay of manpower in health care. Methods: this systematic review is based on a comprehensive search conducted in PubMed, CINHAL, PsycINFO. The two reviewers independently accomplished the full text review for the selected literatures. Results: A total of 11 studies were to the standards of the inclusion criteria. Different methods of studies were applied to measure and evaluate lower back pain among nurses and factors associated with lower back pain. Discussion: Initially, all results/studies were analyzed systemically in grids, and then the results of each study were discussed and interpreted according to the variables, method, and study design.

No abstract

No abstract

BACKGROUND Iatrogenic hypoglycemia is a common occurrence among hospitalized patients and is associated with poor clinical outcomes and increased mortality. Clinical decision support systems could be utilized to reduce the incidence of this potentially avoidable adverse event. OBJECTIVE To determine the desired features and functionality of a real-time informatics alert to prevent iatrogenic hypoglycemia in the hospital setting. METHODS Using the Agency for Healthcare Research and Quality (AHRQ) Five Rights of Effective Clinical Decision Support Framework, we conducted a mixed methods study using an electronic survey and focus group sessions of hospital-based providers. The goal was to elicit stakeholder input to inform future development of a real-time informatics alert to target iatrogenic hypoglycemia. In addition to perceptions about the importance of the problem and existing barriers, we sought input regarding the content, format, channel, timing, and recipient for the alert (i.e. the “Five Rights”). Thematic analysis of focus group sessions was conducted using deductive and inductive approaches. RESULTS A 21-item electronic survey was completed by 102 inpatient-based providers, followed by two focus group sessions (6 providers per session). Respondents universally agreed/strongly agreed that inpatient iatrogenic hypoglycemia is an important problem that could be addressed with an informatics alert. Stakeholders expressed preference for an alert that is non-intrusive, accurate, communicated in near real-time to the ordering provider and provides actionable treatment recommendations. Several electronic medical record tools, including alert indicators in the patient header, glucose management report, and laboratory results section were deemed acceptable formats for consideration. Concerns regarding alert fatigue were prevalent among both survey respondents and focus group participants. CONCLUSIONS The design preferences we identified from this study will provide the framework needed for an informatics team to develop a prototype alert for pilot testing and evaluation. This alert will help meet the needs of hospital-based clinicians caring for patients with diabetes who are at high risk of treatment-related hypoglycemia.