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J O'Malley

Publications and source records attributed to J O'Malley.

At least 37 records · Page 2Linked to original sources

Conspicuity of hepatic metastases on helical CT: effect of different time delays between contrast administration and scanning.

OBJECTIVE: The purpose of this study was to compare two time delays between injection of contrast material and helical CT scanning to determine relative conspicuity of hepatic metastases. SUBJECTS AND METHODS: Twenty-five patients with hepatic metastases were examined with helical CT. The first imaging phase was initiated at 50 sec and the second 75 sec after the start of contrast material injection (3 ml/sec, 150 ml). Differences in lesion and liver attenuation were measured quantitatively. Four radiologists used a 5-point scale to assess lesion conspicuity subjectively. RESULTS: Mean differences in enhancement between liver and lesion were 41 H during the first phase and 59 H for the second phase (p = .0001). Radiologists' conspicuity score averaged 2.4 for lesions in the first phase versus 3.3 for lesions in the second phase (p = .0001). In 56 (88%) of 64 lesions, objective measurements showed greater enhancement of lesions during the later phase. Radiologists found 60 (94%) of 64 lesions to be more conspicuous on these later images. CONCLUSION: Our results show that conspicuity of hepatic metastases on helical CT scans is better with a 75-sec scan delay between contrast administration and scanning than with a 50-sec scan delay. The longer delay time should be used when scanning is used to detect metastases.

Adult↗

Who is the advanced practice nurse?

Challenges and opportunities for Advanced Practice Nurses are explored during the paradigm shift in health care. Role development is presented from a historical perspective, and current role activities are discussed related to accountabilities for care management. Advanced Practice Nurses with practitioner skills of care management coupled with a nursing framework for practice can deliver cost-effective primary care in a variety of settings.

Humans↗

Change ... more change ... and change again!

Change is the only constant in the 1990s. The ongoing redefinition of health care services and provider roles has created unprecedented opportunities. Advanced practice nurses (APNs) can play a major leadership role in determining how these changes in health care will occur. Successful orchestration and management of change by APNs will be critical to accomplishing the transformation of health care in the United States.

Humans↗

Building partnerships.

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Health Services Administration↗

Supporting nursing research. A representative program.

As nurses gain more experience, they often question the basis of nursing practice and want to find answers through clinical nursing research. Completion of a research project, however, often is difficult because of staffing constraints. The authors describe the design and conception of two funded programs that support clinical nursing research in a pediatric tertiary hospital.

Chicago↗

A professional development model: rewarding excellence in nursing practice.

Change continues to be the only constant in health care. The array of rapid and complex changes in the provision of health care services is dramatically affecting the development needs of professional nursing staff. The model presented describes a theoretical framework designed to support the philosophy of both continuous learning and professional development of nurses and also provides a structure for systematic implementation of objectives, content, and learning activities. Linking of professional development models with reward systems is rapidly becoming a successful strategy for organizations in achieving cost-quality outcomes. This model provides a map for staff and management to support, recognize, and reward professional development.

Clinical Competence↗

The redesign agenda.

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Delivery of Health Care↗