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Biomedical subjects

M M Friedman

Publications and source records attributed to M M Friedman.

At least 19 recordsLinked to original sources
PubMed2000

Improving infection control in home care: from ritual to science-based practice.

While many home care policies and procedures are developed with the best of intentions, they frequently lack a scientific basis and have been perpetuated over the years. This article discusses infection control rituals in home care and hospice and the importance of making patient care practice decisions based on sound scientific principles.

Communicable Disease Control↗
PubMed1999

Accuracy and reproducibility of estimating the adequacy of the squamous component of cervicovaginal smears.

In the Bethesda System for reporting cervicovaginal cytology results, 1 criterion for smear adequacy is an adequate squamous component. The accuracy of a cytologist's estimate that 10% of the slide is covered by squamous cells, the adequacy threshold, has not been determined. The percentage of the surface of a glass slide covered by squamous cells was independently estimated by 4 cytologists on 2 occasions by microscopic examination of 83 buccal smears prepared to display estimated coverage of 1% to 20% of the slide surface. The accuracy of visual estimates was compared with measurements by the TracCell System. Each observer made a third set of estimates after receiving 5 slides with known coverage. Median coverage by visual estimation ranged from 4% to 25%, but as measured by the TracCell system was 2%. Median estimated coverage was significantly different for 2 of 4 observers between first and second viewings and between all but 1 pair of observers. For all observers, it was significantly higher than the true coverage. A visual estimate of 10% coverage corresponded to a true median coverage of 3%. When provided with a physical standard, the median estimated coverage by 3 of 4 observers was not statistically different from the true coverage, and interobserver kappa values improved. Unaided visual estimation of the adequacy of squamous cell coverage is neither reproducible nor accurate. What most cytologists consider "adequate" coverage represents only 3% coverage. The availability of a physical standard dramatically increases reproducibility and accuracy.

Cervix Uteri↗
PubMed1999

Putting infection control principles into practice in home care.

Implementing sound, rational infection control practices in home care has been challenging since guidelines, standards, and most references have been developed for the acute care setting. This article provides guidance for adapting appropriate infection control interventions for patient care practices to the home care setting. Such practices include handwashing, home infusion therapy, respiratory care, wound care, urinary tract care, and isolation precautions. Assessment of the home care environment, cleaning and reprocessing of equipment, surveillance, implications for occupational health, and program design are also discussed.

Home Care Services↗
PubMed1999

Preventing and controlling the transmission of antibiotic-resistant microorganisms in the home care setting.

Antibiotic-resistant microorganisms can spread to other home care patients by an infected or colonized patient receiving home care services and the home care staff member unknowingly carrying it to another home care patient's home. Controlling the transmission of antibiotic-resistant microorganisms is the primary responsibility of those providing direct patient care. The ultimate goal for home care is to prevent staff colonization and cross-contamination to other home care patients.

Cross Infection↗
PubMed1997

Social support sources among older women with heart failure: continuity versus loss over time.

The extent to which older women with heart failure experienced continuity or loss of their support sources and the relationship between support source loss, perceived enacted support, and psychological well-being were examined in this study. In-home interviews were conducted with 57 older women who completed two interview 18 months apart following a hospital admission for heart failure. Both the emotional and tangible support sources were quite stable, indicating that the predominant pattern is continuity for older women with heart failure. Loss of tangible support sources was related to a perception of receiving less tangible support and less positive affect. Implications for future research and nursing practice are discussed.

Aged↗
PubMed1997

1997 Joint Commission on Health Care Organizations home care standards: what's new?

Even though there are no new home care standards for 1997, there are some changes in the standards' interpretations and documentation expectations. Not all of the new interpretations are stricter interpretations. In fact, most of the new 1997 standards interpretations are more flexible. New interpretations for other problematic home care standards will be addressed in future columns.

Home Care Services↗