PubMed · 8719561
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C K Yeung. 1995. The normal infant bladder.. https://pubmed.ncbi.nlm.nih.gov/8719561/
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BACKGROUND: To determine the need for placing automated external defibrillators (AEDs) in medical and dental practices, we identified cardiac arrests at these locations. METHODS: Locations of cardiac arrest were abstracted from Emergency Medical Services data from January 1, 1990, through December 31, 1996. We calculated the annual incidence of cardiac arrest per type of practice. RESULTS: There were 142 cardiac arrests in medical or dental practices. Dialysis centers had a relatively high incidence of cardiac arrest (>/=0.746 per practice annually). Cardiology, internal and family medicine, and urgent care centers had a medium incidence (>/=0.01 per practice annually). All other medical and dental practices had a low incidence (</=0.002 annually). CONCLUSIONS: Placement of 779 AEDs in the high- and medium-incidence practices would have provided treatment for 112 patients with cardiac arrest in 7 years. To provide for the 16 cardiac arrests in low-incidence practices, an additional 1928 AEDs would be required.
BACKGROUND: Elevated serum cholesterol levels are associated with increased risk for acute myocardial infarction (AMI) and adverse patient outcomes. It is unclear what proportion of patients have their serum cholesterol levels measured during hospitalization for AMI and are given hypolipidemic therapy. OBJECTIVE: To examine decade-long trends in measurement of serum cholesterol levels during hospitalization for AMI and use of hypolipidemic therapy. METHODS: Observational study of 5204 residents of the Worcester, Mass, metropolitan area hospitalized with validated AMI in all greater Worcester hospitals in seven 1-year periods from 1986 through 1997. RESULTS: Increases in the measurement of serum cholesterol levels during hospitalization for AMI were observed between 1986 and 1991, followed by a progressive decrease; only 24% of patients with AMI in 1997 underwent cholesterol level testing. Younger age, male sex, and absence of a history of cardiovascular disease were associated with an increased likelihood measurement of serum cholesterol levels. Although the relative use of hypolipidemic therapy increased significantly over time (0.4% in 1986 vs 10.7% in 1997), the absolute rate of use remained low. In patients with elevated serum cholesterol levels (>/=6.2 mmol/L [>/=240 mg/dL]), 1.9% received hypolipidemic therapy in 1986 and 36.6% in 1997. CONCLUSIONS: These findings suggest recent declines in the assessment of total cholesterol levels in patients hospitalized with AMI. Although the use of hypolipidemic therapy during hospitalization for AMI has increased over time, considerable room for improvement remains.
BACKGROUND: No state peer review organization has attempted to identify processes of care related to pressure ulcer prediction and prevention in US hospitals. OBJECTIVE: To profile and evaluate the processes of care for Medicare patients hospitalized at risk for pressure ulcer development by means of the Medicare Quality Indicator System pressure ulcer prediction and prevention module. METHODS: A multicenter retrospective cohort study with medical record abstraction was used to obtain a total of 2425 patients aged 65 years and older discharged from acute care hospitals after treatment for pneumonia, cerebrovascular disease, or congestive heart failure. Six processes of care for prevention of pressure ulcers were evaluated: use of daily skin assessment; use of a pressure-reducing device; documentation of being at risk; repositioning for a minimum of 2 hours; nutritional consultation initiated for patients with nutritional risk factors; and staging of pressure ulcer. The associations between processes of care and incidence of pressure ulcer were determined with Kaplan-Meier survival analyses. RESULTS: National estimates of compliance with process of care were as follows: use of daily skin assessment, 94%; use of pressure-reducing device, 7.5%; documentation of being at risk, 22.6%; repositioning for a minimum of 2 hours, 66.2%; nutritional consultation, 34.3%; stage 1 pressure ulcer staged, 20.2%; and stage 2 or greater ulcer staged, 30.9%. CONCLUSION: These results suggest that US hospitals and physicians have numerous opportunities to improve care related to pressure ulcer prediction and prevention.