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Biomedical subjects

A A Nelson

Publications and source records attributed to A A Nelson.

At least 37 records · Page 2Linked to original sources

Developing research hypotheses.

The characteristics of useful research hypotheses are identified and discussed. Research hypotheses should (1) express a relationship between two or more variables, (2) have clear implications for testing, and (3) have measurable variables. Since the hypothesis determines study design, the definition of variables and the level of abstraction contained in its relationship affect the use to which study results can be put. Formulating a hypothesis is of value whenever interpretation of the results is the purpose of a study.

Abstracting and Indexing↗

Effect of pharmacist consultation on rational antimicrobial therapy.

The incidence of rational decisions concerning antimicorbial therapy before and after the establishment of clinical pharmaceutical services in a hospital was compared. A protocol was designed to determine the rationality of physician orders for antimicrobial therapy. This ptocol was used to analyze retrospectively the medical records for patients admitted to a 30-bed surgical unit and a 30-bed medical unit during two months before and after clinical pharmaceutical services were initiated. The results showed that exposure to routine clinical pharmaceutical services appeared to improve prescribing rationality only of drugs used to treat infectious conditions. Since the study design had no control group, the causal effect of clinical pharmaceutical services on the rationality of antimicrobial therapy could not be determined; however, the use of an organized protocol in monitoring antimicrobial therapy allowed an assessment of the use and misuse of antimicrobials in hospitals.

Anti-Bacterial Agents↗

Research design: measurement, reliability, and validity.

The concept of measuring constructs is discussed. An explanation of reliability and validity of measures is presented. Reliability is consistency in measurement over repeated measures. Reliable measures are those with low random (chance) errors. Reliability is assessed by one of four methods: retest, alternative-form test, split-halves test, or internal consistency test. Validity is measuring what is intended to be measured. Valid measures are those with low nonrandom (systematic) errors. Validity is assessed by one of three methods: content validation, criterion-related validation, and construct validation. It is particularly important for the researcher in the behavioral or social sciences to assure himself that measures used are both reliable and valid.

Models, Theoretical↗

Evaluation of the professional communications of a pharmacist in a 45-bed rural hospital with comprehensive pharmaceutical services.

The professional communications of a pharmacist providing comprehensive services were studied to determine the accuracy of the information provided, its usefulness to patient care and the level of expertise needed to respond appropriately. Data were collected by a diary technique for a four-month period. Patient charts were reviewed to collect clinical data needed to evaluate the appropriateness of the pharmacist's responses and to ascertain evidence that the information provided was implemented. The analysis classified the communications as either "clinical" or "pharmaceutical" in content. Practitioner panels of pharmacists and a physician assessed the communications for accuracy, relevance to the patient episode and level of pharmacy expertise necessary to communicate. Most communications with physicians were "pharmaceutical" in content. The most frequent information asked concerned dose or dosage schedule. Approximately one-third of the "pharmaceutical" communications could have been handled adequately by a technician. Only one communication should have required an extensive literature search for the pharmacist to respond. Less than half of the pharmacist's communications were pertinent to the patient episode and of clinical importance. Information from half of the communications was implemented in patient care within 48 hours. There did not appear to be any relationship between accuracy of response and implementation of information. It is not known whether the deficiencies identified apply to a large number of pharmacists. Hence, the bearing of the study on the cost-benefit of clinical pharmacy services is not clear.

Communication↗

Cost of comprehensive pharmaceutical services in a 45-bed rural hospital.

The financial impact of a comprehensive pharmacy program on patient charges and hospital operating costs in a 45-bed community hospital was studied. Data were collected retrospectively for the fiscal year prior to initiating pharmacy services (FY73), the fiscal year during program development (FY74) and the fiscal year following full operations (FY75). The total cost of pharmacy services increased 75% from FY73 to FY75, with the largest dollar increase being in pharmacy salaries. Large increases among other cost items also were noted. The average total cost for pharmacy services increased from $3.28 per patient day in FY73 to $6.04 in FY75 (84%). Total hospital cost per patient day increased by approximately $35 from FY73 to FY75 (5%). The pharmaceutical services fee per dose of medication administered did not change from FY73 to FY75. Patient charges per day for medications and pharmaceutical services increased $0.55 (9.8%) from FY73 to FY75. There was a 55% reduction in the number of items carried in pharmacy inventory from FY73 to FY74 following the initiation of a formulary and a unit dose drug distribution system.

Costs and Cost Analysis↗

A comparison of maintenance and nonmaintenance outpatient prescription directions, durations of coverage, and costs per day.

The purpose of this paper is to present the results of a study on maintenance and nonmaintenance drugs written for outpatients not covered by prescription insurance. The average cost to the patient for a day's supply of drugs, as well as the average dosage, frequency of administration, and length of duration for maintenance and nonmaintenance drugs were examined. The objective of the study was to present the economics and prescribing patterns for the two groups of drugs in order to provide data on the costs involved and the prescribing patterns of physicians. The results of comparing the various components of maintenance and nonmaintenance drugs revealed that significant differences exist in the dosage direction, frequency of administration, units prescribed per day, lengths of duration, costs per day, prescription prices, and quantities prescribed and dispensed. Maintenance drug prescriptions tend to have lower dosage directions, costs per day, and frequencies of administration and higher quantities prescribed and dispensed, prescription prices, and lengths of duration. Two variables, frequency of administration and quantity prescribed, were found to have the greatest influence on the cost per day and length of duration for maintenance drug prescriptions. It is the conclusion of this study that further examination into the factors which influence the physician when he specifies the frequency of administration and quantity to prescribe on maintenance drug prescriptions be conducted.

Analysis of Variance↗

Drug default among schizophrenic patients.

This study attempted to isolate the relationship of two variables that operate to influence drug compliance among schizophrenic patients: the patient's attitude toward his disturbance, and the treatment milieu employed during hospitalization. Schizophrenic patients were administered the Rorschach test upon admission to the psychiatric service of a general hospital to determine their perception of their disturbance. Results of this psychological test were used to randomly select 48 patients who were then randomly assigned to two treatment milius: self-medication during hospitalization and as an outpatient, and traditional drug administration during hospitalization and self-medication as an outpatient. Phenothiazine drugs were used, and compliance was determined by urinalysis. Patients who were generally realistic in their perception of their disorder were significantly more compliant during hospitalization and subsequent outpatient treatment. The treatment milieu variable was not a significant influence. Further analysis via a linear regression model confirmed the relationship of several other compliance factors previously reported in the literature. The role of the patient's attitude toward his illness and the importance of personal relationships are considered in terms of the role of the pharmacist in influencing compliance.

Adult↗