PubMed · 6899043
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L P Sachs. 1980. Performance evaluation.. https://pubmed.ncbi.nlm.nih.gov/6899043/
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This study assesses the ability of primary care physicians to diagnose and manage Pneumocystis carinii pneumonia (PCP) in a standardized patient (SP) with unidentified HIV infection. One hundred thirty-four primary care physicians from five Northwest states saw an SP with unidentified HIV infection who presented with symptoms, chest radiograph, and arterial blood gas results classic for PCP. Seventy-seven percent of the physicians included PCP in their differential diagnoses and 71% identified the SP's HIV risk. However, only a minority of the physicians indicated that they would initiate an appropriate diagnostic evaluation or appropriate therapy: 47% ordered a diagnostic test for PCP, 31% initiated an antibiotic appropriate for PCP, and 12% initiated an adequate dose of trimethoprim - sulfamethoxazole. Only 6% of the physicians initiated adjunctive prednisone therapy, even though prednisone was indicated because of the blood gas result. These findings suggest significant delay in diagnosis and treatment had these physicians been treating an actual patient with PCP.
The authors surveyed 96 hospitals and agencies in Massachusetts to determine: 1) the effect of the changes in health care delivery on RN utilization, particularly baccalaureate nurses, and 2) to identify educational changes necessary to prepare baccalaureate nursing graduates for employment and practice in the future. An analysis of the results of the survey of the 50 nurse executives who responded to the study identifies the projected needs and requirements of the service sector for delivering nursing care, and translates them into suggestions for revisions of the baccalaureate curriculum.
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