Smart and Pervasive Healthcare

Smart and pervasive healthcare aims at facilitating better healthcare access, provision, and delivery by overcoming spatial and temporal barriers. It represents a shift toward understanding what patients and clinicians really need when placed within a specific context, where traditional face-to-face encounters may not be possible or sufficient. As such, technological innovation is a necessary facilitating conduit. This book is a collection of chapters written by prominent researchers and academics worldwide that provide insights into the design and adoption of new platforms in smart and pervasive healthcare. With the COVID-19 pandemic necessitating changes to the traditional model of healthcare access and its delivery around the world, this book is a timely contribution

Clinical Skills Development in the Virtual Learning Environment: Adapting to a New World

The rapid transition to distance learning in response to the unexpected SARS-CoV-2/COVID-19 pandemic led to disruption of clinical skills development, which are typically conducted face-to-face. Consequently, faculty adapted their courses, using a multitude of active learning modalities, to meet student learning objectives in the didactic and experiential settings. Strategies and considerations to implement innovative delivery methods and address potential challenges are elucidated. Furthermore, integration of a layered learning approach may allow for more broad perspectives and allow additional interactions and feedback, which is especially necessary in the virtual environment.https://digitalcommons.chapman.edu/pharmacy_books/1025/thumbnail.jp

Oral Mucosal Microcirculation in the Context of Endotracheal Tube-Related Pressure Ulcer Development.

Ph.D. Thesis. University of Hawaiʻi at Mānoa 2018

Unavoidable Pressure Ulcers: An Ethnonursing Study

Catherine M. Clarey-Sanford Loyola University Chicago UNAVOIDABLE PRESSURE ULCER: AN ETHNONURSING STUDY In an effort to improve patient safety and the quality of care in the acute care setting, there has been an increased focus on the prevention of adverse events believed to be avoidable. Hospital-acquired pressure ulcers (HAPU) have been listed as one of those adverse events, and hospitals are no longer reimbursed for related costs. However, there are patient conditions and clinical situations in which a pressure ulcer can be deemed unavoidable. In acute care, unavoidable means that the patient developed a pressure ulcer even though the provider had: evaluated the patient’s pressure ulcer risk factors; defined and implemented interventions that were consistent with recognized standards of practice; monitored and evaluated the impact of the interventions; and revised the approaches as appropriate. Despite these guidelines, the implementation and documentation of pressure ulcer prevention has been inconsistent, making it difficult to identify a HAPU as unavoidable. There is a lack of research exploring the acute care nurses’ perspective of implementing and documenting pressure ulcer prevention interventions. Using an ethnographic qualitative method, information was collected through observation, informal conversations, interviews, and field notes. Data collection took place in a regional medical center located in the mid-west of the United States over a seven month period and included 23 participants: 7 acute care medical-surgical nurses who had provided direct care to a patient who developed a HAPU and 16 multidisciplinary health care members who had knowledge of pressure ulcer prevention interventions and documentation. A systematic, rigorous, and in-depth qualitative analysis was completed using the Leininger Data Analysis Guide. Four themes emerged from the data regarding the culture of care of adults experiencing a HAPU: incomplete skin assessments were influenced by priority setting and kinship relationships; an inability to implement pressure ulcer prevention interventions was influenced by economical staffing; diverse documentation regimes were influenced by care rationing practices and technical factors; and diverse multidisciplinary collaborative pressure ulcer prevention efforts were influenced by silo social structures. The findings of this study not only have implications for nursing practice, administration, and education, but are vitally important in the identification of a HAPU as avoidable or unavoidable

Design And Implementation Of An Autonomous Wireless Sensor-Based Smart Home

The Smart home has gained widespread attentions due to its flexible integration into everyday life. This next generation of green home system transparently unifies various home appliances, smart sensors and wireless communication technologies. It can integrate diversified physical sensed information and control various consumer home devices, with the support of active sensor networks having both sensor and actuator components. Although smart homes are gaining popularity due to their energy saving and better living benefits, there is no standardized design for smart homes. In this thesis, a smart home design is put forward that can classify and predict the state of the home utilizing historical data of the home. A wireless sensor network was setup in a home to gather and send data to a sink node. The collected data was utilized to train and test a classification model achieving high accuracy with Support Vector Machine (SVM). SVM was further utilized as a predictor of future home states. Based on the data collection, classification and prediction models, a system was designed that can learn, run with minimal human supervision and detect anomalies in a home. The aforementioned attributes make the system an asset for senior care scenarios

Human Factors Considerations in Designing Home-Based Video Telemedicine Systems for the Geriatric Population

Telemedicine is the process of providing healthcare services when large distances separate the patient and the doctor, with the use of communication technology. Telemedicine serves as a substitute to in-person hospital visits and in large, reduces the need to travel and wait in line to visit the doctor. It is predicted to help the geriatric population in managing their healthcare requirements. In order for telemedicine to effectively help the older population, it is essential to understand their needs and issues in telemedicine systems. A study with 40 participants was conducted to understand the usability issues of telemedicine systems with the geriatric population. Four telemedicine video platforms 1) Doxy.me, 2) Polycom, 3) Vidyo and 4) VSee, were used to understand these issues using a between-subject experimental design. Participants completed a demographic survey, followed by a telemedicine session. This was followed by a retrospective think-aloud discussion session to understand their issues and needs concluding with a post-test survey. This survey included general questions about using the system followed by NASA-TLX workload measure and IBM-Computer System Usability Questionnaire (IBM-CSUQ). Some of the issues identified included lengthy email invitation with multiple web links, application download, registration and issues relating to icons used. A Cognitive Task Analysis (CTA) is a method for understanding the cognitive or mental demands involved in performing a task. A Cognitive Task Analysis was conducted for each platform to help identify potential cognitive issues when interacting with telemedicine systems. These solutions include providing a single necessary link in the email, eliminating the necessity to download and register, and, contrast, placement and appropriate labels for icons. As suggested by the participants, detailed step-wise instructions on navigating through a session will also be provided. Future work in this area would be to develop such a system, which theoretically, will increase the efficiency in using telemedicine systems

Taking Note: A Design Solution for Physician Documentation to Balance the Benefits of Handwritten Notes and Electronic Health Records

Master of Design in Integrative DesignUniversity of Michiganhttps://deepblue.lib.umich.edu/bitstream/2027.42/136865/1/THo_2017_MDes-Thesis.pd

Aerospace Medicine and Biology. A continuing bibliography with indexes, supplement 151

This bibliography lists 195 reports, articles, and other documents introduced into the NASA scientific and technical information system in January 1976

The Implementation of Diabetic Foot Care into Primary Care

Diabetes mellitus (DM) is one of the most common metabolic diseases worldwide. It can lead to complications in many parts of the body and can increase overall risk of dying prematurely (World Health Organization (WHO), 2016). Diabetic peripheral neuropathy (DPN) in the feet is one of the most frequent complications of DM (Wang et al., 2017). Other lower extremity complications which can occur as a result of diabetic foot complication (DFC) includes peripheral artery disease (PAD), infection, ulcer and amputation. One of the obstacles for preventing (DFC) is the lack of examinations of the feet in clinical practice (Feitosa et al., 2016). Guided by the Iowa Model Revised (Iowa Model Collaborative, 2017), The purpose of this 12- week project was to implement best practice recommendations for the provision of diabetic foot care into primary care. A review of literature was performed by the project leader (PL) which generated 11 pieces of relevant evidence that met the inclusion criteria. Participants of this project included 531 adult diabetic patients, ages 18-74, who were seen in the primary care setting. Best practice recommendation for interventions included: (a) provider history and foot physical assessment including provider use of the Semmes-Weinstein Monofilament (SWM) tool to assess for actual diabetic foot complication, (b) assessment of footwear, (c) provision of patient education, and (d) initiating multidisciplinary care by educating clinicians, planning a workflow, and providing ongoing feedback. The primary outcome measured was appropriate referrals, defined as a referral to the specialty clinic that is ordered by the provider for individuals with a SWM tool score of 3 and a ‘yes” for referral that has been documented by the provider in the EMR. Findings showed that the interventions improved appropriate referral (X2(1) = 72.657; p \u3c.001), as well as the secondary outcomes of provider foot assessment (X2(1) =93.209; p \u3c.001) and patient follow-up compliance to the Podiatry clinic (PC) following referral (X2(1) = 88.7014; p \u3c.001)

The Implementation of Diabetic Foot Care into Primary Care

Diabetes mellitus (DM) is one of the most common metabolic diseases worldwide. It can lead to complications in many parts of the body and can increase overall risk of dying prematurely (World Health Organization (WHO), 2016). Diabetic peripheral neuropathy (DPN) in the feet is one of the most frequent complications of DM (Wang et al., 2017). Other lower extremity complications which can occur as a result of diabetic foot complication (DFC) includes peripheral artery disease (PAD), infection, ulcer and amputation. One of the obstacles for preventing (DFC) is the lack of examinations of the feet in clinical practice (Feitosa et al., 2016). Guided by the Iowa Model Revised (Iowa Model Collaborative, 2017), The purpose of this 12- week project was to implement best practice recommendations for the provision of diabetic foot care into primary care. A review of literature was performed by the project leader (PL) which generated 11 pieces of relevant evidence that met the inclusion criteria. Participants of this project included 531 adult diabetic patients, ages 18-74, who were seen in the primary care setting. Best practice recommendation for interventions included: (a) provider history and foot physical assessment including provider use of the Semmes-Weinstein Monofilament (SWM) tool to assess for actual diabetic foot complication, (b) assessment of footwear, (c) provision of patient education, and (d) initiating multidisciplinary care by educating clinicians, planning a workflow, and providing ongoing feedback. The primary outcome measured was appropriate referrals, defined as a referral to the specialty clinic that is ordered by the provider for individuals with a SWM tool score of 3 and a ‘yes” for referral that has been documented by the provider in the EMR. Findings showed that the interventions improved appropriate referral (X2(1) = 72.657; p \u3c.001), as well as the secondary outcomes of provider foot assessment (X2(1) =93.209; p \u3c.001) and patient follow-up compliance to the Podiatry clinic (PC) following referral (X2(1) = 88.7014; p \u3c.001)