Clinical indicators of infant irritability.
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Biomedical subjects
Publications and source records attributed to C Kleiber.
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The health care system can be characterized, among other facts, by the multiplicity of involved actors (institutions and individuals) acting for final goals in competition, or even in opposition. The principal goal of the economic organization of the health care system consists in applying a regulation to grant the coordination of the great number of decisions taken by decentralized actors in order to introduce them in economic way into a common final goal. The market forces appear unable to realize the necessary regulation in the health care system and centralized planning can lead to lack of effectiveness. For this reason, it's necessary to make use of a decentralized economic regulation; in this view health care financing systems are essential and could positively influence the behaviour of the actors as well as the costs. Information on hospital Casemix represents an important contribution to better transparency of the working of the health care system and to facilitate competition.
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Anesthetized, intubated kittens were subjected to one of two procedures: (1) insertion of a suction catheter to a predetermined distance and withdrawal with or without the application of suction or (2) insertion of the catheter until resistance was met and withdrawal with or without the application of suction. There were 5 animals in each group. All 10 of the animals in the "predetermined distance" groups had normal tissues. Of the 10 animals in the "resistance" groups, nine displayed multifocal areas of denuded epithelium and varying degrees of inflammation. One subject from the "resistance/suction" group had normal tissues. One from the "resistance/no suction" group displayed a small hemorrhage into the soft tissue. The Kruskal-Wallis rank test revealed a significant difference (p less than 0.05) between the "predetermined" and the "resistance" groups. The application of suction had no effect on the amount of damage evident.
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The present quantitative importance of prevention is in Switzerland extremely low in comparison to the health budget of the national community. It has taken in recent years increasing place however in speeches and talks as well as in medical thinking. Prevention presently tends to be seen as a medical specialty among others and perhaps prefigures a new form of medicine, the object of which would be the societal body more than the body of the sick individual. In this perspective (would that be good?), a new type of physician-informatician-statistician might be trained, with the mission to manage and supervise the health status of the population. Preventive health action through the environment at large could fulfill an important role in the foreseeable developments. New health "morals" are currently emerging, which are bringing together numerous adepts. This might mean that the time of a "health society" (or health-determined society) is not far.
A recently developed intraoral device is being used for infants who require orotracheal and orogastric intubation. The purpose of the appliance is to prevent complications associated with long-term intubation, such as palatal groove formation, acquired cleft palate, defective primary dentition, and chronic irritation of the airway. The nursing care required for an infant with this intraoral appliance is described. The procedure for daily removal of the appliance, oral hygiene, and assessment of the oral cavity is presented. Other nursing interventions addressed include provision of non-nutritive sucking, initiation of oral feedings, and parent teaching and support.
The purpose of this meta-analysis was to estimate the effects of heparin flush and saline flush solutions on maintaining patency, preventing phlebitis, and increasing duration in peripheral heparin locks. The average effect size (d value) across 15 studies with a total sample size of 3,490 was .0573 for patency (clotting). The 95% credibility interval ranged from -.2267 to .3413. The average effect size across 13 studies with a total sample size of 2,356 was -.0757 for phlebitis. The 95% credibility interval ranged from -.2497 to .0983. The average effect size for duration across six samples with a total sample size of 1,960 was -.0550. The 95% credibility interval ranged from -.2424 to .1324. It can be concluded that saline is as effective as heparin in maintaining patency, preventing phlebitis, and increasing duration in peripheral intravenous locks. Quality of care can be enhanced by using saline as the flush solution, thereby eliminating problems associated with anticoagulant effects and drug incompatibilities. In addition, an estimated yearly savings of $109,100,000 to $218,200,000 U.S. health care dollars could be attained.
Circumstances accompanying spontaneous endotracheal extubation (SE) in neonates reveal a trend that very low birth weight infants who are ventilated for several weeks are most prone to this complication.
In September/October 1988, Pediatric Nursing published a pediatric intensive care unit (PICU) flow sheet for documenting assessments and nursing interventions. In this article, a hospital's pediatric flow sheet that allows for entries related to general pediatric practice is presented. It decreases the amount of time required to chart as well as the number of medical record forms used to comply with JCAHO standards for nursing documentation.
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From a retrospective chart audit conducted on 59 infants and children who had survived open-heart surgery, 16.9% were found to have developed ulcers on the occipital region of their scalps during the postoperative period. Four risk factors were identified: age, type of congenital heart defect, length of time intubated, and length of stay in the pediatric intensive care unit (PICU). A protocol designed to decrease the amount of pressure and shearing force applied to the occipital region of these patients postoperatively was implemented. A dramatic decline to 4.8% in the incidence of pressure ulcers was noted after implementation of the protocol.