Complete Documentation Research Articles

Technologies to support nursing students in learning Standardized Nursing Languages: A systematic literature review.

This review identifies technologies used to teach Standardized Nursing Languages and their impact on nursing students' educational outcomes. A literature review, updated to June 14, 2024, was conducted by consulting the PubMed, CINAHL, Scopus, and Cochrane databases. The main inclusion criterion was primary studies in which technology was used to educate students on Standardized Nursing Languages. Three types of technology were addressed: Computerized Aids and Electronic Devices, Decision Support Systems, and Diagnostic Reasoning Software. Most of these technologies were found to positively impact knowledge, performance, application of the nursing process, diagnostic accuracy, and clinical reasoning. Integrating technology into nursing education enhances nursing students' skills and equips them to handle the digital aspects of modern health care. Technologies must support all stages of the nursing process, reinforce clinical reasoning, and offer timely feedback. Additionally, the presence of teachers during technology training is crucial to ensure proper functioning, provide technical support, manage the learning environment, and verify students' skills. Nursing students with technological skills will become nurses capable of producing complete and quality clinical documentation and supporting their professional achievements.

Development and Validation of an Instrument to Assess Quality and Completeness of Medication-Related Discharge Documentation.

Transitions of care are periods of heightened risk of medication management errors. Poor-quality discharge documentation has been linked to incorrect or suboptimal medication use and unplanned hospital visits. Despite regulations defining essential components of medication-related discharge documentation, deficiencies persist, highlighting the need for a method to assess whether current clinical practice meets these standards. To conduct an initial validation of a newly developed instrument, the Complete Medication Documentation at Discharge - Measure (CMDD-M), assessing the quality and completeness of medication-related discharge documentation in a Swedish clinical setting. The instrument was developed and refined in multiple stages. In this study, two clinical pharmacists and one geriatrician independently applied the final instrument to discharge documentation from 50 patients. Inter-rater reliability (IRR) was evaluated using linear and quadratic weighted Cohen's κ (κW linear and κW quadratic). The average CMDD-M score, based on the consensus of the three raters, was 3.40 (SD ± 2.50) out of nine possible points across the patients' discharge documentation. The IRR between the pharmacists' individual assessments demonstrated almost perfect agreement, with κW linear and κW quadratic values of 0.92 (95% CI: 0.80-1.00) and 0.97 (95% CI: 0.85-1.00), respectively. Moreover, the IRR between the pharmacists' consolidated score and the geriatrician's assessment displayed a moderate to strong agreement, with κW linear and κW quadratic values of 0.64 (95% CI: 0.48-0.80) and 0.80 (95% CI: 0.64-0.97), respectively. The CMDD-M demonstrated robust IRR confirming its ability to consistently and accurately measure the quality and completeness of medication-related discharge documentation in an easy-to-use form. Further research is recommended to ensure validity, generalisability and association with clinically relevant outcomes supporting the instrument's potential usefulness for evaluating and improving clinical practice and research.

Assessment of Real-Time Natural Language Processing for Improving Diagnostic Specificity: A Prospective, Crossover Exploratory Study.

Background Reliable, precise, timely, and clear documentation of diagnoses is difficult. Poor specificity or the absence of diagnostic documentation can lead to decreased revenue and increased payor denials, audits, and queries to providers. Nuance's Dragon Medical Advisor (DMA) is a computer-assisted physician documentation (CAPD) product. Natural language processing is used to present real-time advice on diagnostic specificity during documentation. Objectives This study assessed the feasibility, acceptability, and preliminary efficacy of real-time CAPD in improving diagnostic specificity and in turn reducing clinical documentation improvement burden. Methods This prospective, crossover trial recruited 18 hospitalists employed by Lifespan Health System and assigned them randomly to two groups. Each group first completed documentation using either traditional clinical documentation improvement (CDI) methods or CDI + DMA real-time advice for eight weeks and then crossed over. Metrics from Epic's EMR and Nuance administrative tools as well as anonymous surveys and one-on-one interviews were collected and analyzed. Results Hospitalists had 29% fewer standard CDI queries using DMA with CDI (IRR: 0.71; 95% CI: 0.37,1.39). Self-reported ability to predict clarification requests improved by 1 point on average (1.00; 95% CI: 0.32,1.67) on the Likert scale. This benefit was kept even after DMA was stopped and the group reverted back to CDI only. Qualitative survey reports indicated overall ease of use and educational benefits. Additional work needs to be done to determine if there is significant increase in note-writing time or reimbursement. Conclusions Hospitalists using DMA spent less time responding to In-basket queries. There was a strong educational opportunity, and the tool was easy to use. DMA offers promise for improving diagnostic specification while minimally impacting provider workflow.

Derivation of atmospheric reaction mechanisms for volatile organic compounds by the SAPRC mechanism generation system (MechGen)

Abstract. This paper describes the methods that are used in the SAPRC mechanism generation system, MechGen, to estimate rate constants and derive mechanisms for gas-phase reactions of volatile organic compounds (VOCs) in the lower atmosphere. Versions of this system have been used for over 20 years in the development of the SAPRC mechanisms for air quality models, but this is the first complete documentation of the scientific basis for the chemical mechanisms it derives. MechGen can be used to derive explicit gas-phase mechanisms for most compounds with C, H, O, or N atoms. Included are reactions of organic compounds with hydroxy (OH) and nitrate (NO3) radicals, O3, and O3P; photolysis or unimolecular reactions; and the reactions of the radicals they form in the presence of O2 and oxides of nitrogen (NOx) at lower-atmospheric temperatures and pressures. Measured or theoretically calculated rate constants and branching ratios are used when data are available, but in most cases rate constants and branching ratios are estimated using various structure–reactivity or other estimation methods. Types of reactions include initial reactions of organics with atmospheric oxidants or by photolysis; unimolecular and bimolecular reactions of carbon-centered, alkoxy, and peroxy radicals; and those of Criegee and other intermediates that are formed. This paper documents the methods, assignments, and estimates currently used to derive these reactions and provides examples of MechGen predictions. Many of the estimation methods discussed here have not been published previously, and others have not been used previously in developing comprehensive mechanisms. Our knowledge of atmospheric reactions of organic compounds rapidly and continuously evolves, and therefore mechanism generation systems such as MechGen also need to evolve to continue to represent the current state of the science. This paper points out areas where MechGen may need to be modified when the system is next updated. This paper concludes with a summary of the major areas of uncertainty where further experimental, theoretical, or mechanism development research is most needed to improve predictions of atmospheric reaction mechanisms of volatile organic compounds.

An ontology to describe the damage process to built cultural heritage triggered by earthquakes: The CHEDO model

Information on cultural heritage is critical both to understand its value and to support management. Collecting, managing, visualizing, and sharing this information requires standardization. In the last decades, architecture has advanced in information management with the implementation of Building Information Modelling (BIM) methodology. The application of this methodology to cultural heritage has associated challenges due to the complexity and heterogeneity of the information. The integration of ontologies and BIM allows obtaining semantically enriched digital models, which has led to a growing interest in the field of architectural cultural heritage. In this article, the Cultural Heritage Earthquake Damage Ontology (CHEDO) model is presented. This ontology has been designed to document damage and loss caused by earthquakes in cultural heritage, through its integration into BIM systems interconnected with databases, although this integration is not addressed in the present work. The CHEDO model integrates terms and relationships to document the damage process in relation to the building characteristics (architectural, spatial, constructional, and geometrical) and the physical environment of the same. This model, by providing a comprehensive description of the building and its environment, allows for complete and accurate documentation of damage, which supports the planning of post-earthquake restoration and reconstruction. To facilitate interoperability with parallel ontologies in close domains of architectural cultural heritage, CHEDO was designed taking as reference the high-level ontology Conceptual Reference Model (CRM) developed by the International Committee for Documentation (CIDOC), of the International Council of Museums (ICOM). The proposed ontology is structured in four blocks: 'building and surrounding environment', to describe the building and its environment; 'building damage', to represent the damage and its causes; 'location', to describe the location of the building and the external processes; and 'terminology', to categorise and classify certain classes of the ontology.

Continuous individual feedback to nurses at emergency medical dispatch centres: a stepped-wedge, interrupted time series analysis.

Clinical feedback is often lacking in prehospital care, and while performance data is increasingly available to clinical and operational leadership, it is seldom made available to care providers themselves. In this study, we investigate the impact of a simple intervention consisting of the provision of monthly feedback reports via email to emergency medical dispatch nurses in three Swedish regions. Individualised reports consisting of 14 measures divided into descriptive (eg, priority-setting and call times), process (eg, dispatch times and documentation completeness) and outcome (eg, over/under triage rate) categories were developed with staff and management input. Report delivery was implemented using a stepped-wedge design, and effects were evaluated using a hierarchical regression-based interrupted time series analysis. 40 dispatchers were included in the study between March 2020 and October 2023, who handled a total of 246 353 incidents. Some impacts on documentation-related process measures were identified, with the odds of complete documentation increasing by 7.5% (95% CI 5.1 to 9.9) and the odds of having a documented contact reason increasing by 3.8% (1.5-5.9). These effects remained robust over the post-intervention period. Weaker impacts on outcome measures were identified which could be explained by a higher priority given to emergency medical dispatches overall. Providing performance data can influence care providers to adjust their behaviour to improve process-related quality metrics under their direct control. The intervention may also have induced nurses to more often upgrade the priority of their patients. Improving outcome metrics may however require more intensive, multifaceted interventions.

Treatment initiation and completion among head and neck squamous cell carcinoma patients in Tanzania.

Few studies characterizing clinical outcomes of head and neck cancer (HNC) patients in sub-Saharan Africa report the proportion of patients who initiate and complete treatment, information integral to contextualizing survival outcomes. This retrospective cohort study describes HNC patients who presented to Muhimbili National Hospital and Ocean Road Cancer Institute in 2018, the highest-volume oncology tertiary referral centers in Tanzania. Logistic regression was applied to assess predictors of treatment initiation and completion. Among the 176 head and neck squamous cell carcinoma (HNSCC) patients, 34% (59) had no treatment documented, 34%(59) had documentation of treatment initiation but not completion, and 33%(58) had documentation of treatment completion based on the modalities started. Univariate logistic regression showed that late-stage disease was associated with increased odds of initiating treatment (OR 8.24, 95% CI 2.05-33.11, p = 0.003) and trends toward completing treatment (OR 7.41, 95% CI 0.90-60.99, p = 0.063). At last visit, 36.9%(65) were alive with a median follow up of 5.6 months (IQR 1.64-12.5 months). A large proportion of HNC patients who presented to MNH and ORCI did not initiate or complete treatment. These metrics are critical to contextualize care outcomes of HNC patients in resource-constrained health systems and develop interventions.

Study of Thyroid Disorders in Patients of Stroke

To study the prevalence of thyroid disorders among patients of ischemic stroke and to correlate it with the severity of stroke on basis of NIHSS score and functional outcome after 3 months on basis of modified Rankin Scale (mRS).1 Method: This hospital based descriptive, randomized, single blinded, analytical study was done in the department of Medicine, SRIMSR hospital, Raipur from September 2023 to Dec2024. A total of 82 patients above 18 years of age who had ischemic stroke were included. Every patient was subjected to detailed clinical history and neurological examination. Two neurological scores, namely NIHSS (National Institutes of Health Stroke Scale) and modified Rankin Scale (mRS) was used. The severity distribution of NIHSS score on admission was divided into 3 categories, mild: NIHSS <8; moderate: 8-14; severe: >14. Neurological impairment and improvement were assessed using NIHSS, together with modified Rankin Scale (mRS)[1,2] from follow up OPD visits. Favorable outcome is defined as mRS<2[3]. The first OPD follow up usually occurs 2-4 weeks after discharge from hospital and we have assessed clinically after 3 months of discharge. Basic and clinical characteristics including demographic data such as sex, age, concurrent illness, medication was collected and categorized. We have divided patients into 5 group on the basis of serum free T3 (FT3), free T4 (FT4) and TSH; NTIS, Euthyroid, Hyperthyroid, Overt hypothyroid & Subclinical hypothyroid (SCH) [4]. Results: Among 82 patients with available laboratory data and relatively complete neurological impairment documentations met all inclusion criteria, 59 men and 23 women. Patients with subclinical hypothyroid had significantly mild neurological impairment at presentation on basis of NIHSS score (P = < .05) and have good functional outcome on follow up after 3 months on basis of mRS score. Conclusion: on the basis of this study it can be concluded that ischemic stroke patients with subclinical hypothyroid (SCH) at presentation has less stroke severity and these group of patients have better functional outcome at 3 months of follow up but further studies with large sample size are needed to validate our findings. Keywords: Thyroid disorder, stroke, cerebrovascular accident, modified Rankin Scale (mRS), National Institutes of Health Stroke Scale (NIHSS)

"The problem is not detection, it is treatment": Exploring Why Women Needing Pre-Cervical Cancer Care are Lost to Follow-Up at the Hospital in Iquitos, Peru.

Background The objective of this study was to investigate the barriers to follow-up of women with cervical lesions suspicious of cancer who were ineligible for primary-level treatment and needed, but did not receive, hospital-level care in Loreto, Peru. Methods In-depth, semi-structured interviews were conducted with 18 HPV-positive women requiring hospital-level follow-up care for cervical lesions suspicious of cancer but for whom there was no documentation of completion of treatment. After thematically analyzing these patient interviews, interview findings were presented to seven doctors and five nurse-midwives at both the hospital and the primary levels for comments and suggestions regarding barriers to treatment. Finally, all findings were presented at a group model building workshop with 19 health authorities and professionals, where action items were discussed to elicit suggestions for systems-level changes. Results Interviewed patients and healthcare professionals expressed the need to improve communication between levels of care, as well as the need to implement a patient navigation program. Interviewees also discussed the barriers patients encountered in obtaining hospital-level follow-up that ultimately affected their continuum of care. Patient-identified barriers to hospital care were grouped into three main themes: (1) limited patient understanding of treatment steps, (2) the need for multiple trips to the hospital to obtain care, and (3) lack of provider follow-up, leading to their suggestion for (4) the need for patient navigators. The healthcare professionals concurred with the barriers identified by the patients, but further elucidated suggestions for change such as (1) prioritizing patients with a high risk of cancer when referring to the hospital, and (2) increasing communication between the different levels of care. The group model building workshop served as a space to discuss findings and action items that could potentially make these changes possible. Conclusions Despite an overall increase in follow-up for HPV-positive women since the implementation of the new HPV-based screen-and-treat program, women at high risk of developing cervical cancer are still being lost to follow-up after being referred to the hospital for care. The challenges faced by both providers and patients are complex and require systems-level improvements.

Legal Analysis of Bank Compliance in Implementing the Principle of Prudence in Credit with Trade Receivables Fiduciary Guarantee

prudential principle is a fundamental pillar in maintaining the stability and security of bank finances, especially in the distribution of credit with fiduciary guarantees for trade receivables. Credit secured by trade receivables has special characteristics that require a more in-depth risk evaluation, given the intangible nature of receivables and dependence on the ability of third parties to pay. This study discusses how the prudential principle is applied by banks in the process of creditworthiness analysis, assessing the quality of trade receivables as collateral, and managing related risks, including liquidity, default, and legal risks. In addition, this study highlights the importance of fiduciary registration and complete legal documentation to protect banks from potential legal disputes and ensure effective collateral execution in the event of default. By implementing strict prudential principles and comprehensive risk management, banks can minimize the risks associated with the distribution of credit guaranteed by fiduciary on trade receivables, thereby maintaining their financial and operational stability.

A EFETIVIDADE DO DIREITO PREVIDENCIÁRIO E A IMPORTÂNCIA DA JUSTIÇA GRATUITA NA JUSTIÇA FEDERAL: DESAFIOS E PERSPECTIVAS

This article aims to analyze the effectiveness of Social Security Law at a global level, highlighting its purpose, objectives and challenges faced. The effectiveness of Social Security Law in society is crucial to guarantee financial support and dignity to people in times of vulnerability, such as old age, illness or disability. To obtain social security benefits, it is necessary to meet specific requirements, such as presenting complete documentation and proving disability or minimum age. Through bibliographic research and inductive methods, it is noted that Social Security is a vital tool for social protection, but faces bureaucratic challenges, lack of information and regional inequalities that can make access difficult. It is essential to continue improving public policies to ensure that all citizens can exercise their social security rights effectively and equitably. Therefore, the application of free justice at the federal level, highlighting its main objectives and developments, in order to guarantee everyone the right to seek judicial protection free of charge. Because of this, it promotes more inclusive justice. Furthermore, through specific rules and regulations, it allows low-income citizens to have their rights protected, regardless of their economic conditions.

P118 Palmoplantar psoriasis: association with comorbidities

Abstract Introduction Palmo-plantar psoriasis (PP) is a localized form of psoriasis that can affect only palms and/or soles in the absence of psoriatic lesions in any other parts of the body or may accompany psoriatic lesions elsewhere. Term ‘Psoriatic disease’ refers reveals systemic impact of the disease. Some publications reveal correlation between psoriasis severity and affected area (BSA) with higher risk of comorbidities. The aim of this study was to reveal comorbidities in palmoplantar psoriasis patients with relatively low BSA percentage, but still high disease burden. Materials and Methods Data was collected from October 2022 till January 2024. Forty-five patients with isolated palmoplantar psoriasis were included into study if complete medical documentation was available and histological diagnosis of PP was approved. Paediatric patients were excluded from the study. Results A total of 45 patients with PP were included into research. Thirty patients (66.66%) had at least one comorbidity with the disease duration from 1 to 4 years. From 30 patients with comorbidities 53.3% had primary arterial hypertension (35.5% in total). 20% had gastrointestinal disease [incl. ulcerative colitis, hepatic steatosis, gastroduodenal ulcer, GERD (13.3% in total)]. Dyslipidaemia was present in 16.6% in this group (11.1% in total) ; bronchial asthma in 13.3% (8.8% in total); and diabetes mellitus second type, haemolytic anaemia, psoriatic arthritis, neurologic disorders (incl. insomnia, anxiety, depression: each in 6.66% (4.4% in total). Autoimmune thyroiditis was revealed in 3.3% from PP patients with comorbidities and 2.2% in total. Conclusions The obtained results are consistent with literature data on the association between psoriasis and arterial hypertension. Palmoplantar psoriasis patients with relatively low percentage of affected skin area reveals most concomitant associated diseases—cardiovascular, gastrointestinal, neurological etc. The risk of developing hypertension is elevated in patients not only with severe psoriasis, but also in PP. Further investigation should be performed to determine association with metabolic syndrome and disease duration as well as comprehensive cardiovascular risk assessment in this population.

Does staff gender matter for project performance in international organizations? Evidence from the Asian Development Bank

ABSTRACT The performance of aid projects matters for development. Yet what shapes performance is insufficiently understood. According to interdisciplinary research on organisational management and bureaucratic representation, the gender of operational leaders in complex organisations can have a discernible effect on all aspects of the project cycle. Using a novel dataset specifically constructed for this research from complete documentation available for 3,500 Asian Development Bank projects, the analysis examines whether the gender of project leaders matters in explaining variation in project performance. These projects are targeted financial investments and technical support programmes implemented by Asian Development Bank in developing countries to build infrastructure, strengthen social services, and boost economic development. The study tests this relationship using multinomial-ordered logistic regressions and entropy matching. Testing the hypothesis that women’s leadership positively influences project outcomes, the analysis finds significant positive associations with efficiency ratings, while associations with relevance, effectiveness, and sustainability, though positive, are not statistically significant. This article contributes to the literature by estimating the differential impact of women vs men project managers on disaggregated performance measures. This research establishes potential mechanisms and opens avenues for future discourse.

The impact of a dedicated checklist on the quality of onsite management of critically buried avalanche victims in cardiac arrest in a Swiss helicopter emergency medical service

BackgroundThe management of avalanche victims in cardiac arrest (CA) is a challenging situation for rescuers. Despite existing specific management algorithms, previous studies have reported poor compliance with international guidelines and incomplete documentation and transmission of the information required for patient management. The Avalanche Victim Resuscitation Checklist (AVRC) was developed in 2014 in response by the International Commission for Mountain Emergency Medicine. Our aim was to assess the impact of the AVRC on the quality of onsite management of critically buried avalanche victims in CA, i.e. the compliance of management with international guidelines and the completeness of documentation of avalanche specific information.MethodsWe assessed compliance and documentation in a Swiss helicopter emergency medical service (HEMS) between January 2010 and April 2020. Victims buried for more than 24 h were excluded.ResultsIn the 10-year study period, 87 critically buried avalanche victims in CA were treated by the HEMS, 44 of them after the introduction of the AVRC. Enough information was available to assess management compliance in over 90% of cases (n = 79). Inadequate management (n = 25, 32%) and incomplete documentation occurred more often in patients with a long burial duration. After the introduction of the AVRC, the compliance of patient management with the guidelines increased by 36% (from 59 to 95%, p < 0.05) and led to complete documentation of the required information for patient management.ConclusionsThe use of the AVRC improves the quality of management of critically buried avalanche victims in CA and ensures complete documentation of avalanche specific information. Quality improvement efforts should focus on the management of avalanche victims with a long burial duration. The use of the AVRC enables identification and appropriate treatment of patients with hypothermic cardiac arrest.

Primary Intraosseous Solitary Fibrous Tumor of the Mandible: Report of a Diagnostically Challenging Case with NAB2::STAT6 Fusion and Review of the Literature.

Solitary fibrous tumor (SFT) represents an uncommon mesenchymal neoplasm affecting primarily the extremities and deep soft tissues with, overall, benign but locally aggressive biologic behavior and an underlying pathognomonic NAB2::STAT6 fusion. Intraosseous SFTs are infrequent, and involvement of the jawbones is exceedingly rare. A 54-year-old woman presented with an asymptomatic, well-demarcated, multilocular radiolucency of the left posterior mandible featuring focally irregular borders, root resorption and lingual cortex perforation. The lesion had shown progressive growth over a 6-year period. Microscopically, a proliferation of predominantly ovoid and spindle-shaped cells with indistinct cell membrane borders, elongated, plump or tapered, hyperchromatic nuclei, and lightly eosinophilic cytoplasm was noted. Marked cytologic atypia, pleomorphism and mitoses were absent. A secondary population of epithelioid cells exhibiting ovoid or elongated vesicular nuclei, and abundant, pale eosinophilic or vacuolated cytoplasm was also present. The supporting stroma was densely fibrous with areas of marked hyalinization and variably-sized, ramifying, thin-walled vessels. By immunohistochemistry, lesional cells were strongly and diffusely positive for STAT6 and CD99, and focally immunoreactive for MDM2 and SATB2. Ki-67 was expressed in less than 5% of lesional cells, while most interspersed epithelioid cells were positive for the histiocyte marker, CD163. Molecular analysis disclosed a NAB2::STAT6 fusion confirming the diagnosis of SFT. The patient underwent segmental mandibulectomy. Herein, we report the first case of primary intraosseous SFT of the mandible with complete documentation of its characteristic immunohistochemical and molecular features. Diagnosis of such unusual presentations may be further complicated by the challenging histomorphologic diversity of SFT.

Management of the Inflatable Penile Prosthesis Reservoir at time of revision surgery: remove, retain, or recycle?

Three common strategies exist for managing the inflatable penile prosthesis reservoir during revision surgery: the original reservoir can be (a) removed, (b) deactivated and left in situ, sometimes referred to as "drain and retain" (DR), or (c) validated and reconnected to new cylinders, which we have termed "reservoir recycling" (RR). To compare the efficacy and safety of the RR approach to penile prosthesis revision against DR and the recommended approach of complete device removal and replacement. A retrospective chart review of our single-surgeon inflatable penile prosthesis database between 2007 and 2022 was performed, identifying revision surgeries. Cases were stratified by reservoir management technique. Patients who had undergone at least 1 follow-up visit and had complete documentation regarding reservoir handling were included. Reservoir-related complications necessitating surgical intervention such as infection and device failure were compared between the 3 groups using a chi-square test. Mean follow-up duration, time to revision, and operative time were also assessed. The primary outcome was theincidence of reservoir-related complications requiring surgical intervention and secondary outcomes included time to revision surgery and operative time. Among 140 patients meeting inclusion criteria, 62 underwent full reservoir replacement (FR), 48 DR, and 30 RR. Compared to FR, DR and RR groups had similar mean time to revision and intraoperative time. Follow-up duration was similarly limited for all 3 groups at a median of approximately 4.5months. There were no postoperative infections in the RR cohort. However, when compared to the DR and FR groups, this did not reach significance (P = .398). There was no difference in mechanical failure rate between the 3 groups (P = .059). Nonmechanical failure was also similar between all 3 groups (P = .165). These results suggest that RR exhibits comparable outcomes to DR and FR, making it a viable option during select penile prosthesis revision surgeries, potentially decreasing morbidity without compromising outcomes. This is the first study to evaluate outcomes after RR. Limitations include small sample size, limited follow-up, and single-surgeon experience. There was no difference in reservoir-related complications when comparing the 3 methods. These preliminary results suggest that reservoir recycling may provide a safe and effective reservoir-handling alternative in inflatable penile prosthesis revision surgery.

BindCompare: a novel integrated protein-nucleic acid binding analysis platform.

Advanced genomic technologies have generated thousands of protein-nucleic acid binding datasets that have the potential to identify testable gene regulatory network (GRNs) models governed by combinatorial associations between factors. Transcription factors (TFs), and RNA binding proteins (RBPs) are nucleic-acid binding proteins regulating gene expression and are key drivers of GRN function. However, the combinatorial mechanisms by which the interactions between specific TFs and RBPs regulate gene expression remain largely unknown. To identify possible combinations of TFs and RBPs that may function together, developing a tool that compares and contrasts the interactions of multiple TFs and RBPs with nucleic acids to identify their common and unique targets is necessary. Therefore, we introduce BindCompare, a user-friendly tool that can be run locally to predict new combinatorial relationships between TFs and RBPs. BindCompare can analyze data from any organism with known annotated genome information and outputs files with detailed genomic locations and gene information for targets for downstream analysis. Overall, BindCompare is a new tool that identifies TFs and RBPs that co-bind to the same DNA and/or RNA loci, generating testable hypotheses about their combinatorial regulation of target genes. BindCompare is an open-source package that is available on the Python Packaging Index (PyPI, https://pypi.org/project/bindcompare/) with the source code available on GitHub (https://github.com/pranavmahabs/bindcompare). Complete documentation for the package can be found at both links.

PRESCRIPTION AUDIT AT A TERTIARY CARE HOSPITAL – A CROSS-SECTIONAL STUDY

Objective: The aim of this study was to analyze prescribing practices at Silchar Medical College and Hospital (SMCH) through a cross-sectional audit of 600 outpatient prescriptions, adhering to the National Health Mission Prescription Audit Guidelines 2021. Methods: The audit examined prescriptions of patients who visited the Outpatient department (OPD) of Department of General Medicine, Surgery, Orthopedics, Gynecology and Obstetrics, Pulmonary Medicine, Pediatrics, Dermatology, and Psychiatry. The audit evaluated key aspects such as the completeness of patient information, legibility of prescriptions, documentation of clinical details, and adherence to standard treatment guidelines (STG). Results: The prescription audit at SMCH revealed high compliance with essential criteria such as OPD registration and patient gender documentation. However, gaps were identified in areas such as allergy status documentation (0%), legible handwriting (75.7%), and follow-up advice (16.9%). In addition, adherence to STG was observed in 75% of prescriptions, with a concerning finding that there was a lack of facility’s Antibiotic Policy. Conclusion: The study underscores the importance of complete and accurate prescription documentation to ensure patient safety and effective treatment.

Achieving and sustaining reduction in hospital-acquired complications in an Australian local health service

BackgroundReducing the prevalence of hospital-acquired complications (HACs) is paramount for both patient safety and hospital financial performance because of its impact on patient’s recovery and health service delivery by diverting...

Juridical Analysis Of The Delegation Of Authority Of Doctors To Nurses In Health Services At Health Centers

This study aims to analyze the juridical aspect of the delegation of authority from doctors to nurses in health services in health centers. Delegation of authority is an important process in the implementation of health services, especially in health centers, which often face limited human resources. This study uses a normative approach by analyzing applicable laws and regulations, including the Medical Practice Law, the Nursing Law, and other related regulations. The results of the study show that the delegation of authority from doctors to nurses must be based on clear and specific legal provisions to ensure the legality and safety of patients. Complete and accurate documentation of the patient's medical record is essential to maintain transparency and accountability in the delegation of authority process. In addition, the delegation of authority must be carried out by considering the competence and qualifications of nurses, and accompanied by adequate supervision from the doctor who provides the authority. This study concludes that although delegation of authority is a common and necessary practice in health services in Puskesmas, its implementation must be strictly regulated and supervised to ensure that the health services provided remain in accordance with professional standards and applicable laws.