Impact of Laboratory Value Flowsheet in Electronic Health Record (EHR) Documentation Time

Research on the use of EHR is contradictory since it presents contradicting results regarding the time spent documenting. There is research that supports the use of electronic records as a tool to speed documentation;and research that found that it is time consuming. The purpose of this quantitative retrospective before-after project was to measure the impact of using the laboratory value flowsheet within the EHR on documentation time. The research question was: “Does the use of a laboratory value flowsheet in the EHR impact documentation time by primary care providers (PCPs)?” The theoretical framework utilized in this project was the Donabedian Model. The population in this research was the two PCPs in a small primary care clinic in the northwest of Puerto Rico. The sample was composed of all the encounters during the months of October 2019 and December 2019. The data was obtained through data mining and analyzed using SPSS 27. The evaluative outcome of this project is that there is a decrease in documentation time after implementation of the use of the laboratory value flowsheet in the EHR. However, patients per day increase therefore having an impact on the number of patients seen per day/week/month. The implications for clinical practice include the use of templates to improve workflow and documentation as well as decreasing documentation time while also increasing the number of patients seen per day. .

Other Cities’Distribution Institutions for Publishing Books in Modern Chinese Libraries:Taking Huating Bookstore,the Shanghai General Distribution Office of Modern Zhejiang Library,as an Example

Many modern Chinese libraries have established distribution agencies in other cities to distribute books published or sold on consignment.Huating Bookstore,which was once the Shanghai General Distribution Office of Zhejiang Library in modern times,is one of them.On the basis of a brief description of modern Zhejiang Library and its book publishing,as well as the overview of Huating Bookstore,the paper introduces and analyzes the ZPL Publishing Book Catalogue sent by Huating Bookstore,and the ZPL publishing and selling consignment books issued by Huating Bookstore.It points out that Huating Bookstore is a bridge between the ZPL located in Hangzhou and various retail ZPL publishing bookstores in Shanghai.Their production and sales relationship is a mutually beneficial one.

The practice and reflection of providing the Interlibrary Loan and Document Delivery Services in Vocational Colleges libraries

Abstract ： Interlibrary Loan and Document Delivery Service is the major form for libraries to share resources.The librairies of universities or colleges can better guarantee the supply of document information ,accommodating to users＇ need for documents to the greatest extent.This article elaborates on the definition of Interlibrary Loan and Document Delivery as well as their significance with a key focus on the Interlibrary Loan and Document Delivery practice of Oriental Vocational and Technical College in Zhejiang, meanwhile it also puts forward some suggestions on how to better practisee the service of lnterlibrary Loan and Document Delivery.

An overview of current document delivery and interlibrary loan services of Chinese libraries

In this article, the author introduces the basic information and the historical development of document delivery and interlibrary loan services conducted by Chinese libraries at different organizational levels and in different geographical areas. It compares and analyzes the commonalities, peculiarities and service-effectiveness of three most important systems of document delivery and interlibrary loan currently available in China. The author also discusses the developing trend of such services in the future.

Documentation Concordance,Sharing and Utilization of Tea Germplasm Resources in Yunnan

In this paper,the research achievements and progress of Yunnan tea germplasm resource in past sixty years are systematically reviewed from the following aspects：exploration,collecting,conservation,protection,identification,evaluation and shared utilization.Simultaneously,the current problems and the suggestions about subsequent development of tea germplasm resources in Yunnan were discussed,including superior and rare germplasm collection,tea genetic diversity research,biotechnology utilization in tea germplasm innovation,super gene exploration and function,the construction of utilization platform,biological base of species and population conservation.

Library-Inside:AI赋能图书馆新质生产力的一种基础模型

AI正引发知识服务的生产力×生产关系的革命性变革,迫切需要推动AI与图书馆服务深度融合,打造符合新的发展理念的先进生产力质态。本文提出,从第一性原则思维出发,面向复杂适应性系统,以问题驱动和场景驱动的创新和设计驱动的创新,不断演进发展AI赋能的图书馆服务的新质生产力。在回归原点分析“人们到图书馆干什么”的基础上,基于大语言模型+AI智能体提供的能力,提出Library-Inside作为AI赋能图书馆新质生产力的一种基础模型,并描述了三种可能的实现模式:Library-Inside 1.0作为用户知识应用的智能助手,Library-Inside 2.0作为用户知识生产的智慧座舱和Library-Inside 3.0(Library×)打造用户AI赋能知识生产力的生态养育站。本文指出,要以战略创新推动图书馆新质生产力发展,要注意克服战略创新中的内在的结构性缺失和系统性偏差。

Assessing adequacy of emergency provider documentation among interhospital transferred patients with acute aortic dissection

BACKGROUND: Acute aortic dissection(AoD) is a hypertensive emergency often requiring the transfer of patients to higher care hospitals; thus, clinical care documentation and compliance with the Emergency Medical Treatment and Active Labor Act(EMTALA) is crucial. The study assessed emergency providers(EP) documentation of clinical care and EMTALA compliance among interhospital transferred AoD patients.METHODS: This retrospective study examined adult patients transferred directly from a referring emergency department(ED) to a quaternary academic center between January 1, 2011 and September 30, 2015. The primary outcome was the percentage of records with adequate documentation of clinical care(ADoCC). The secondary outcome was the percentage of records with adequate documentation of EMTALA compliance(ADoEMTALA). RESULTS: There were 563 electronically identified patients with 287 included in the final analysis. One hundred and five(36.6%) patients had ADoCC while 166(57.8%) patients had ADoEMTALA. Patients with inadequate documentation of EMTALA(IDoEMTALA) were associated with a higher likelihood of not meeting the American Heart Association(AHA) ED Departure SBP guideline(OR 1.8, 95% CI 1.03–3.2, P=0.04). Male gender, handwritten type of documentation, and transport by air were associated with an increased risk of inadequate documentation of clinical care(IDoCC), while receiving continuous infusion was associated with higher risk of IDoEMTALA.CONCLUSION: Documentation of clinical care and EMTALA compliance by Emergency Providers is poor. Inadequate EMTALA documentation was associated with a higher likelihood of patients not meeting the AHA ED Departure SBP guideline. Therefore, Emergency Providers should thoroughly document clinical care and EMTALA compliance among this critically ill group before transfer.

Evaluation of a Mobile Station Electronic Health Record on Documentation Compliance and Nurses’ Attitudes

Electronic Health Record (EHR) Systems have been adopted by healthcare organizations for documentation of patient care. Often these information systems are embedded in mobile nurse stations. As part of assessing the impact of this technology it is important to determine the effect it has on charting compliance and user acceptance. Data were collected at a medical center in Taiwan in two stages. The first stage involved use of a 28-item medical review tool to measure charting compliance in 99 charts before and after implementation of the EHR system. In stage two, a survey was conducted with 709 nurse users to determine their level of mobile EHR acceptance 3 months after this documentation technology was initiated. Results demonstrated that EHR significantly improved documentation compliance in standardized data entry format (name, date, time), abbreviation, content correction/revision, patient care needs, and care goals. Analysis of data from the five categories of a user acceptance survey revealed the following results (based on a 4-point Likert scale): patient care (2.92), nursing efficiency (2.78), education and training (2.98), usability (2.61), and usage benefits (2.87). The study concluded that use of mobile nurse stations with EHR can improve documentation compliance and that although frequent system downtime needs improvement, nurses generally have positive attitudes toward this technology application.

Assessing an Educational Program to Improve Documentation and Reduce Pain in Hospitalized Patients

Few experimental studies have evaluated the efficacy of continuing educational programs aimed at the improvement of nurses’ pain-management skills. This study assessed whether a standardized educational program aimed at nurses could increase the use of the Numeric Rating Scale-11 in both documenting and reducing postoperative pain-intensity levels in hospitalized surgical patients. The study had a quasi-experimental pre- and post-intervention design. Data were collected from records of surgical patients prior to and after the standardized educational program was completed. There were no significant differences between pre- and post-intervention groups in terms of either pain-documentation frequency or pain-intensity level. The study showed no increase in the frequency of postoperative pain documentation and no reduction of surgical patients’ postoperative pain-intensity level. This finding indicates that the standardized educational program on postoperative pain management was insufficient to bring about changes in clinical practice.

The Role of Library and Information Science Education in the Development of Community Health Information Services for People Living with HIV/AIDS: Perspectives of Directors and Managers of Public Libraries

This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are presented from semi- structured qualitative interviews that were conducted with eleven directors and managers of local branches in the Knox County Public Library (KCPL) System that is located in the East Tennessee region in the United States. Select feedback reported by research participants is summarized in the article about strategies in LIS education that can help local public librarians and others in their efforts to become more responsive information providers to PLWHA. Research findings help better understand the issues and concerns regarding the development of digital and non-digital health information services for PLWHA in local public library institutions.

Impact of an educational intervention on medical records documentation

BACKGROUND: Inaccurate and incomplete documentation can lead to poor treatment and medicolegal consequences. Studies indicate that teaching programs in this field can improve the documentation of medical records. The study aimed to evaluate the effect of an educational workshop on medical record documentation by emergency medicine residents in the emergency department.METHODS: An interventional study was performed on 30 residents in their first year of training emergency medicine(PGY1), in three tertiary referral hospitals of Tehran University of Medical Sciences. The essential information that should be documented in a medical record was taught in a 3-day-workshop. The medical records completed by these residents before the training workshop were randomly selected and scored(300 records), as was a random selection of the records they completed one(300 records) and six months(300 records) after the workshop.RESULTS: Documentation of the majority of the essential items of information was improved significantly after the workshop. In particular documentation of the patients' date and time of admission, past medical and social history. Documentation of patient identity, requests for consultations by other specialties, first and final diagnoses were 100% complete and accurate up to 6 months of the workshop.CONCLUSION: This study confirms that an educational workshop improves medical record documentation by physicians in training.

Virtual Home Library System—— Let every Chinese family having their own libraries

Virtual Home Library (VHL) is an integrated IT system that utilizes virtual reality technology and an IPTV set-top box (STB) to virtually construct a ‘library’ and the relevant reading environment on televisions in people’s home. Unlike the online e-book reading applications, Virtual Home Library can be applied on televisions – the world’s most convenient and most efficient communication tool. Providing extended digital library services, it will be a perfect group reading utility for family readers. The system has been investigated by a joint research team formed by the National Library of China and the Communication University of China, collaborating with a Chinese IPTV equipment manufacturer. This paper presents some preliminary investigations of the VHL system performed by the research team.

The Nursing Documentation Dilemma in Uganda: Neglected but Necessary. A Case Study at Mulago National Referral Hospital

In Uganda, nursing documentation still remains a challenge, in most of the government hospitals and some private hospitals, it remains at a manual (non-technology driven) level and omissions have been observed. Nurses continue to capture standard elements in their documentation. A mixed methods intervention study was conducted to determine knowledge and attitudes of nurses towards documentation, including an evaluation of nurses’ response to a designed nursing documentation form. Forty participants were selected through convenience sampling from six wards of a Ugandan health institution. The study intervention involved teaching nurses the importance of documentation and using of the trial documentation tool. Pre- and post-testing and open-ended questionnaires were used in data collection. The results from the close-ended questions were presented in the previous publication;the responses from the open-ended questions would then be presented. The open-ended questions regarding comments about the nursing documentation process and suggestions about the process of implementing the nursing documentation system in the ward units were considered. All participants were provided the opportunity to provide personal comments, reflections, or stories of their experiences with documentation in patient care. A thematic analysis approach was used during data analysis. The results showed that the participants had positive attitude towards documentation of patient care, but they had constraints limiting them to document, they reflected issues concerning the perceived pressure from the administrations and support to document. The study findings have implication that there is need for organizational support and to have multisite studies and extension of the documentation tool.

Medical Records Documentation of HIV/AIDS Clinical Services at Primary Health Care (PHC) Facilities and Its Implications on Continuum of Care and Operational Research in South Africa

Background: Patients medical records are used to document care processes for communication amongst healthcare workers for continued patient management. Incomplete or inaccurate documentation can adversely affect the quality of patients’ care, leading to medication and treatment errors, increased morbidity, and mortality. Quality documentation in medical records is therefore an essential component of optimal healthcare and facilitates an individual’s continuity of care. This study aimed to assess the quality of documentation of clinical data through the review of the accuracy and completeness of clinical records among newly diagnosed HIV-positive persons. The study is a sub analysis of a prospective longitudinal study that followed a cohort of 12,413 persons who were newly diagnosed with HIV infection. Severe limitations in retrieving reliable information and data became an obstacle to our research and led the study team to conduct medical records documentation and data audit to verify the accuracy and completeness of the data for newly diagnosed HIV positive persons. Methods: A cross-sectional study was conducted using routine data generated from 75 randomly selected newly diagnosed HIV positive persons aged 12-years-old and above between June 1, 2014 and March 31, 2015 in 36 purposively selected primary health care (PHC) clinics in South Africa. The facilities were selected from three high HIV-burden districts of South Africa (Gert Sibande, uThukela and City of Johannesburg). Results: Significant differences in the accuracy and completeness of clinical records were observed between data generated through the self-assessment by the facility managers and data primarily collected through review of the patients’ clinical stationery and facility registers. 80% of the newly diagnosed HIV positive persons were not documented as screened for tuberculosis (TB) on the clinical chart and 69% of newly diagnosed clients were not clinically staged (WHO staging). Furthermore, 80% of newly diagnosed HIV positive persons’ follow up visit dates were not documented in the patient’s clinical chart. Completeness of the data elements on the case record forms ranged from as low as 26% to a maximum of 66%. It was noteworthy that all the clients’ information documented in HIV counselling and testing registers, continuum of care registers and clinical charts were only partially completed. Conclusion: Each of the health care facilities under study had some significant gaps in medical records documentation of clinical data on newly diagnosed HIV positive persons. Data and information accuracy and completeness were a serious challenge in most facilities during the period under investigation. Of interest was the inconsistency of data recorded in the HCT registers, continuum of care and clinical charts of individual patients. This is a major impediment to HIV/AIDS comprehensive care.

Towards Lightweight Requirements Documentation

Most requirements management processes and associated tools are designed for document-driven software development and are unlikely to be adopted for the needs of an agile software development team. We discuss how and what can make the traditional requirements documentation a lightweight process, and suitable for user requirements elicitation and analysis. We propose a reference model for requirements analysis and documentation and suggest what kind of requirements management tools are needed to support an agile software process. The approach and the reference model are demonstrated in Vixtory, a tool for requirements lightweight documentation in agile web application development.

Layered Documentation On the Process of Documenting Contemporary Dance and Physical Theatre

How can choreography and physical theatre pieces continue to perpetuate the work after rendering？ How to preserve their aura, their dynamics, and their ephemeral and genuine nature, as Walter Benjamin said？ In 1936, Benjamin already anticipated in The Work of Art in the Age of lts Technological Reproducibility that something is missing even in the best-finished reproduction. And memories of dance and physical theatre are intricate. The question is how to create a type of documentation that does not betray the vital flow of the event-based phenomenon. In this short article we will see a series of choreographic and performance artists like Esther Ferrer, Ayara Hern^indez Holz, and Olga de Soto who claimed a new form of organic documentation, making it turn performance or memory of viewers. Other creators as the company La Fura dels Baus claim documentation as spectacle and others on the opposite side, as Tino Sehgal propose radically non documentation of their work. Precisely, these different positions coincide with those of thinkers like Peggy Phelan, Sarah Bay-Cheng, or Paula Caspao who respect to a range of documentation and how it can never replace the live art.

Health Workers’ Documentation Process as a Prerequisite to the Integration of Patient Care at a Regional Referral Hospital in Uganda

Background: Integrated patient care is necessary for better care outcomes. Documentation enhances the integration of care;however, in the Ugandan setting, documentation of care is poor (e.g., omissions and incomplete records) and integration of patient care is not visible. This study presents a review of patient health records that was undertaken to understand documentation of care at a regional referral hospital in Eastern Uganda. This information will help in developing a documentation model to facilitate the integration of patient care in Uganda. Methodology: This retrospective review involved 513 patient health records from the medical-surgical, pediatric, and obstetric/gynecological departments of Jinja Regional Referral Hospital. Data were collected using checklists. Stratified sampling was used to capture variations in ward unit records and identify a fair representation of each department. Data were analyzed with descriptive and inferential statistics. All analyses were performed with SPSS version 22. Results: On average, the study hospital attended to 1000 patients per day and discharged 100 patients per ward unit per month. Our record review showed that documentation by both nurses and doctors was incomplete, and care was fragmented. However, doctors documented care more often than nurses, although the integration of patient care was not evident in doctors’ documentation. Conclusion: To establish integrated patient care, documentation must meet standards set by relevant professional bodies. The findings of this study will inform the development of a feasible documentation model to facilitate the integration of patient care in Uganda.

Build A “Domestically Best and World Leading” Library——An Interview With Sun Yigang, Deputy Librarian of the National Central Library

Statistics show that, in 2016, the National Central Library had has more than 1.27 million books, 36.46million volumes of documents, 1323 TB of digital resources, nearly 5.64 million visitors, nearly 25 million copies of literature and held 4,400 social education activities including exhibitions, lectures, training,universal reading and art popularization, benefiting more than 1.73 million people. All these figures reveal the achievements of the National Central Library in enriching the collection resources and providing public cultural services in the past five years.

In search of service innovations by public libraries in Chinese urban centers:A case study of Dongguan Library

This article introduces several of the more significant service delivery innovations and their resulting accomplishments instigated by Dongguan Library(thereafter abbreviated as DGL) in recent years. The textual exposition of this paper is based on a case study of DGL by this author about its user-centered vision, mission, immediate objectives and the exhibited service performance within a contextual environment of collegial support from its professional peers. After a five-year period of intensive efforts on such focused professional development and practice, DGL has completed its information service mapping and information delivery for the entire municipality of Dongguan on a 7-day and twentyfour-hour(7/24) basis. This singular feast of accomplishment seems to suggest the moral that any significant development of scale of a municipal library has to be in keeping pace closely with the progress of the society at large in general and with the changing information demands of its local clientele in particular.

Designing a Document Retrieval Method for University Digital Libraries Based on Hadoop Technology

With the development of big data,all walks of life in society have begun to venture into big data to serve their own enterprises and departments.Big data has been embraced by university digital libraries.The most cumbersome work for the management of university libraries is document retrieval.This article uses Hadoop algorithm to extract semantic keywords and then calculates semantic similarity based on the literature retrieval keyword calculation process.The fast-matching method is used to determine the weight of each keyword,so as to ensure an efficient and accurate document retrieval in digital libraries,thus completing the design of the document retrieval method for university digital libraries based on Hadoop technology.