Biomedical subjects
Publications and source records attributed to R Kirk.
The paper describes the use of the MIDIGRID and MIDICREATOR systems with a range of transducers and interface devices in music therapy. This opens up new possibilities, as well as new challenges in the way in which such technology may be used in therapy. The paper includes a discussion of the role of music therapy, together with some case histories involving the use of these systems.
A PCR assay has been developed for the detection of Campylobacter jejuni and Camp. coli in water samples. The sample is filtered through a membrane which is subjected to sonication to release the impacted cells. After removal of the filter from the cell suspension and a freeze/thaw cell lysis step, a semi-nested PCR is carried out on the filtrate using the primers CF02, CF03 and CF04 (Camp. jejuni flaA and flaB gene sequences). Incorporation of a sonication stage allows removal of the filter membrane since they have been shown to inhibit the PCR. In experiments with spike water samples (20 ml) a theoretical sensitivity of 10-20 campylobacter cells ml-1 was achieved. Using a sample volume of 100 ml this sensitivity can be increased to approximately 2 campylobacter cells ml-1.
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Cost management is a six-step process that begins with identifying important activities of patient care, identifying desired outcomes of patient care, and the most predictable and efficient process to be used to ensure outcome accomplishment. The more caregivers and managers understand the cost-benefit connection between patient care and resource costs, the easier it will be for them to manage (rather than be a victim of) quality, productivity, and profitability.
The pressure to improve the quality of clinical and customer service outcomes continues to escalate. In most cases, sustained improvement (either incremental or breakthrough) is a direct result of improving service delivery and work processes. The challenge, for managers, is to design work processes that predictably lead to satisfying and cost-effective results. Total quality management (TQM) and continuous quality improvement (CQI) may seem like "this year's fads," but they are form, not fashion. TQM and CQI processes generate a customer-responsive environment in which employees can contribute to achieving the organization's mission, vision, and strategic objectives.
How would you like to be responsible for an organization that achieved positive patient results, satisfied high-performing nurses, and had a healthy bottom line? Here's a common sense quality management model sophisticated enough to meet your needs and simple enough to implement at all levels of your organization.
Reimbursement, budget, and nurse availability constraints no longer support the quality-at-any-cost concept. However, clear definitions of clinical and satisfaction outcomes, nursing responsibilities that contribute to those outcomes, and reasonable time targets for staff contributions can help nurses at all levels analyze and prioritize work load to build new or update existing acuity systems. The author describes specific methods nurse executives and managers can use to involve and guide staff members in (1) determining realistic and compatible standards of care, performance, and resource productivity, (2) integrating quality-based time standards into acuity systems, and (3) using acuity information to manage delivery of a targeted, desired level of ongoing quality care.
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In an attempt to detect markers of significance of coagulase-negative staphylococci (CNS) isolated from neonatal blood cultures, epidemiological data and the rate of appearance of positive blood cultures were examined. The main epidemiological factor studied was the relative abundance of the different biotypes of CNS in blood cultures, on neonatal skin and the hands of neonatal unit staff. Our results showed that the relative recovery rates of biotypes found from these sources showed no significant differences. The number of positive blood culture bottles in each set and the number of days taken for growth to appear showed wide variations. A higher proportion of aminoglycoside-resistant strains were found in the group showing both blood culture bottles positive and in the group where isolates were obtained by 24 h of incubation. We conclude that there is no advantage in biotyping CNS in assessing clinical significance, but the association of aminoglycoside resistance with the isolation pattern of CNS in neonatal blood cultures requires further examination.
An 18-month-old girl presented with cardiac tamponade five weeks after varicella. An emergency pericardiocentesis was performed and, subsequently, an anterior pericardiectomy. She eventually made a complete recovery following corticosteroid treatment.
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Clearly, both the nurse executive and nurse manager roles are becoming more complex. I feel an enthusiasm by the professionals in those positions to pursue development activities that will help them do their jobs better and with less discomfort. Nurse executives obviously know the power of combining knowledge with experience. How do the different leadership and management development needs identified by these NE fit with your organization's needs? What is the content in your leadership and management development programs? Are your programs meeting the real needs of your executive and management-level staff? One way to find out is to do a simple survey. Today, nurse executives are responsible and accountable for challenges we never considered possible, even a few years ago. But along with the new challenges came the flexibility and positive attitudes of NEs to respond to changes and acquire new skills such as cost accounting, computers, or marketing. It's this type of proactive thinking that helps nurse leaders turn problems into opportunities and their situations into success stories.
This study was conducted to explore whether the quality of provider care may contribute to blood pressure reduction and whether other factors related to the treatment of hypertension may explain decline in blood pressure. In the study, 46 uncontrolled (greater than or equal to 140/90 mm Hg), medically treated hypertensive patients who received more personalized care differed significantly in the magnitude of blood pressure reduction from 36 usual-care patients (10/7 vs 2/2 mm Hg means for systolic and diastolic blood pressure reduction, respectively). About twice as many experimental patients as controls were reclassified as having "controlled" blood pressure, and this difference reached statistical significance. A multiple regression analysis for personalized-care subjects showed that no dynamic variables were related to blood pressure changes. It was postulated that more personalized care may have accounted for the significant difference between groups in blood pressure reduction. Similar personalized monitoring services might be important additions to usual medical care in order to control blood pressure more fully in high-risk hypertensive patients.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A time series "reversal" design demonstrated that behavioral counseling increased medication adherence from about 60 to 100% for a black, hypertensive patient. However, inadequate pharmacological treatment yielded no clinically important blood pressure decrease. The combination of improved compliance and minimal blood pressure reduction led the patient's physician to explore higher doses and alternate medications to achieve blood pressure control. The physician's aggressive medical treatment was initiated only after the patient's compliance had been improved. Thus, this study suggests that paraprofessional counseling can increase compliance and illustrates the need for both behavioral and physiological data in clinical management to avoid blaming patients for poorly controlled blood pressure.