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1.
J Emerg Nurs ; 40(1): 46-50, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23142099

RESUMO

OBJECTIVE: This study examined the accuracy of temporal artery and axillary temperatures compared with rectal temperatures in pediatric ED patients younger than 4 years. METHODS: A method-comparison study design was used to examine the agreement between a temporal artery or axillary thermometer and a nondisposable, rectal electronic thermometer, which is the clinical reference standard for temperature measurement in children. Temperatures were taken with each device in a convenience sample of stable, pediatric ED patients who were younger than 4 years. Bias and precision were calculated to quantify the differences between the 2 devices, as well as the percentage of temporal artery and axillary temperatures that were >±1.0°C and >±1.5°C higher or lower than the rectal temperature. RESULTS: A total of 52 pediatric ED patients were studied over a 10-month period. Bias and precision for the temporal artery and axillary devices were -0.46°C ± 0.50°C and -0.93°C ± 0.49°C, respectively. The percentage of temporal artery and axillary temperatures that were >±1.0°C and/or >±1.5°C above or below the clinical reference temperature were 15% and 6%, respectively, for the temporal artery thermometer and 39% and 14%, respectively, for the axillary thermometer. DISCUSSION: Bias and precision values for the temporal artery, but not the axillary temperature, were within the acceptable range set by experts to use as a noninvasive substitute for core body temperature measurements. If properly used by ED staff, temporal artery thermometers could be used to obtain temperature in pediatric patients younger than 4 years, thus avoiding physical and psychological discomfort for the child and parent associated with obtaining rectal thermometers.


Assuntos
Temperatura Corporal/fisiologia , Serviço Hospitalar de Emergência , Febre/diagnóstico , Reto , Artérias Temporais , Termômetros/estatística & dados numéricos , Pré-Escolar , Enfermagem em Emergência/métodos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Enfermagem Pediátrica/métodos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
2.
Appl Clin Inform ; 15(1): 129-144, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-38354837

RESUMO

BACKGROUND: Given the inequities in access to health care resources like COVID-19 vaccination, health systems should carefully consider how to reach underrepresented groups. Reflecting on vaccine rollout efforts holds insight on the role of community engagement and informatics support in promoting health equity. OBJECTIVES: This study aimed to assess the effectiveness of four outreach strategies deployed by University of Washington (UW) Medicine in improving vaccine equity over traditional vaccine scheduling online or by phone, we report on appointment scheduling and completion of appointments (i.e., vaccine administration) through (1) automated outreach to individuals from underrepresented groups, (2) temporary "pop-up" clinics in neighborhoods highly impacted by COVID-19, (3) vulnerable population clinics, and (4) mobile vaccine vans. METHODS: We conducted a 6-month retrospective analysis of electronic health records (EHR) to describe the sociodemographic characteristics of individuals who scheduled appointments using the outreach strategies and characteristics associated with a greater likelihood of vaccine administration based on appointment completion. To help explain trends in the EHR data, we engaged 10 health system leaders and staff who spearheaded the outreach strategies in follow-up conversations to identify qualitative insights into what worked and why. RESULTS: Compared with traditional scheduling, all outreach strategies except vulnerable population clinics had higher vaccine appointment completion rates, including automated outreach (N = 3,734 [94.7%], p < 0.001), pop-up clinics (N = 4,391 [96.0%], p < 0.001), and mobile vans (N = 4,198 [99.1%], p < 0.001); and lower cancellation rates, including automated outreach (N = 166 [1.1%], p < 0.001), pop-up clinics (N = 155 [0.6%], p < 0.001), and mobile vans (N = 0 [0%], p < 0.001). Qualitative insights emphasized ongoing community partnerships and information resources in successful outreach. CONCLUSION: Vaccine equity outreach strategies improved the proportion of patients who scheduled and completed vaccination appointments among populations disproportionately impacted by COVID-19. Engaging community partners and equity-focused informatics tools can facilitate outreach. Lessons from these outreach strategies carry practical implications for health systems to amplify their health equity efforts.


Assuntos
COVID-19 , Vacinas , Humanos , Vacinas contra COVID-19 , Estudos Retrospectivos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Informática
3.
Am J Infect Control ; 50(11): 1266-1267, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35307472

RESUMO

There have been many tactics throughout the years aimed at reducing central line-associated bloodstream infections (CLABSI) in the healthcare setting. To reduce CLABSI rates at this facility, we employed cognitive science-based online training directed at nursing departments. Following implementation, we found significant reductions in CLABSI rates that were sustained for a minimum of 9 months. These results demonstrate that this learning methodology can be used to help decrease CLABSI and potentially other health care-associated infections.

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