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Biomedical subjects

M F Pranulis

Publications and source records attributed to M F Pranulis.

15 recordsLinked to original sources
PubMed1997

Nurses' roles in protecting human subjects.

This article highlighted several nursing roles and strategies for the protection of human subjects including the importance of socializing new nurses into their role responsibilities and reporting questionable scientific conduct. Although different strategies were suggested in relation to each role, one commonality pervaded--nurses, by virtue of their license and focus of their professional discipline, are keys to the protection of human subjects in research.

Clinical Nursing Research↗
PubMed1997

Strategies for provider reimbursement. Should physician pay exceed that of mid-level practitioners?

It is clear that the bitter disputes over power and control in health care have been dysfunctional. The issue of reimbursement equity for nurse practitioners who provide primary care services is only one of many numerous, complex issues--each of which has many underlying and unresolved elements contributing to the dysfunctionality of the contemporary health care system. What is needed is a united effort and interdisciplinary collaboration to: a) address the maldistribution and excessive costs of health care, b) reevaluate all aspects of healthcare including who carries out what functions at what level of educational preparation and reimbursement, and c) redesign a system that is efficient, effective, and economical. It is imperative that individual nurses and physicians as well as organized medicine and nursing work with each other and with other health care providers, payors, regulators, suppliers, and most especially consumers to restructure health care and redefine roles. Doing so requires divestment of self-interests and a dispassionate focus on the mission and goals of the system. Using a conceptual model facilitates analysis of the literature, specific issues, and their impact on the system. However, resolution of the issues and improving the health care system's functionality requires commitment to the goal regardless of personal cost. This is the challenge confronting all of us.

Economic Competition↗
PubMed1996

Protecting rights of human subjects.

A significant problem exists with the volume of human subjects research that is being carried out by investigators who are not in compliance with the Belmont Report's guidelines for the protection of human subjects. Numerous reasons exist for noncompliance, which may create dilemmas for resolving this issue. However, it is important that health care organizations-regardless of size-take a proactive position in addressing this problem. This article has briefly described the nature, scope, and underlying dilemmas of this issue and has suggested a strategy for resolving the issue at an organizational level. As patient advocates by virtue of their professional licenses, nurses in any role can and must take a lead in protecting human subjects' rights.

Ethics, Nursing↗
PubMed1992

Ethical considerations for quality assurance versus scientific research.

There is increasing evidence to support the contention that the boundaries between QA and scientific clinical research are blurred. This blurring is of particular concern in relation to the protection of human subjects rights (Brett & Grodin, 1991). The article thus concludes that it is essential that proposals for QA programs undergo periodic appraisal by an institutionally responsible, disinterested review panel. It further concludes that it is essential to submit proposals for all prospective QA projects, potentially scientifically meritorious QA projects, and all scientific clinical research projects to an institutional review board (IRB) to render decisions about the protection of human subject's rights before accessing data. Doing so protects the subject's rights, protects the investigator from unwittingly rendering harm rather than good, and enhances the ethical credibility of the projects. It also protects the investigator from embarrassing and potentially litigious situations. It is also incumbent on IRBs to develop efficient, effective, and expeditious review processes that encourage rather than discourage the a priori review process.

Confidentiality↗
PubMed1972

"United we stand"...

Explore the source record for details and available documents.

Delivery of Health Care↗
PubMedDate not supplied

Reproducibility of impedance cardiography hemodynamic measures in clinically stable heart failure patients.

BACKGROUND AND AIMS. One of the greatest challenges confronting physicians who are managing the care of patients with heart failure is to acquire objective data that signals treatment effectiveness and/or disease progression. The aim of this study was twofold: 1) to determine the extent to which (real time) impedance cardiography measurements obtained with a specific medical device (the BioZ) were reproducible in outpatients with clinically stable heart failure; and 2) to establish "normal" ranges of one week hemodynamic variability in this population of patients. Information of this nature would help clinical cardiologists and primary care practitioners to evaluate the implications of their patient's visit-to-visit hemodynamic variability. METHODS. A one group, prospective, time series design was used. The sample consisted of 62 patients who had clinically stable heart failure and who were being treated in an outpatient heart failure clinic at a university medical center. BioZ hemodynamic measures of cardiac output, contractility, and after load were obtained at five points in time: two, 10, and 60 minutes resting following a 40-50 foot walk on the first day and at two and 10 minutes resting following a 40-50 foot walk on the second day, one week later. RESULTS. Small but significant changes in cardiac output and cardiac index (mainly due to changes in heart rate) were seen during the 60-minute period on week one. Stroke index did not change during this period. In general, reproducibility between measurements taken on the same day and between days was quite good. Establishment of 95% confidence intervals helped define boundaries of variability in this population. Further clinical evaluation of the four patients whose values exceeded the 95% confidence intervals revealed unexpected, potentially relevant changes that could have accounted for their interday variability. Conclusion. The BioZ impedance cardiography measurements are responsive to hemodynamic activity-rest changes and are reproducible at a one week interval in clinically stable heart failure patients being treated in an outpatient clinic. Stroke index is a better measure of patient status than cardiac output or cardiac index. (c)2000 by CHF, Inc.

Journal Article↗
PubMedDate not supplied

Impedance cardiography: a bridge between research and clinical practice in the treatment of heart failure.

This paper proposes that impedance cardiography could narrow the gap between heart failure clinical research and the appropriate and timely application of new knowledge and technology in the care of patients with heart failure. Research variables and measurement strategies, identified in the heart failure scientific literature between 1994-1999, are compared to measures that can be obtained through a cost effective, noninvasive technology--impedance cardiography. Emphasis is placed on case reports that illustrate how "real time" evaluation and trending of key hemodynamic variables through impedance cardiography monitoring has been used to apply state of the science knowledge and technology to improve the inpatient and outpatient management of care for patients with severe heart failure. (c)2000 by CHF, Inc.

Journal Article↗
PubMedDate not supplied

Impedance cardiography (ICG) noninvasive hemodynamic monitoring provides an opportunity to deliver cost effective, quality care for patients with cardiovascular disorders.

Hemodynamic evaluation is an essential component in diagnosing cardiovascular disorders and managing patient care. There are numerous invasive, semi-invasive, and noninvasive methods available for evaluating hemodynamic function, which vary widely in equipment, procedural complexity, cost, quality of data, and risks. This paper summarizes information needed for administrative decision-making about employing one method--ICG hemodynamic monitoring--and provides an overview of the technology, its accuracy and reproducibility, clinical applications, financial consideration and references for further evaluation of the technology.

Cardiography, Impedance↗
PubMedDate not supplied

Identifying nurses vulnerable to role conflict.

To remedy the nursing shortage in the US, hospitals initially focused on expensive recruitment efforts to fill nursing vacancies. Few addressed a core component of the problem: role conflict, which when reduced can be instrumental in hospitals attracting and retaining nurses.

Adult↗