Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Inpatients”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 631 records · Page 35Linked to original sources
PubMed1996

Depressive symptoms attributable to medication exposure in a medical inpatient population.

OBJECTIVE: Exposure to certain drugs-angiotensin-converting enzyme inhibitors, beta-blockers, calcium channel blockers, corticosteroids. H2 blockers, and sedative hypnotics-may be associated with an increased risk of depression. These drugs are commonly used in inpatient medical therapeutics. Since population attributable risk (PAR) is generally related both to strength of association and to the frequency of exposure to a risk factor, the PAR of depressive symptoms associated with these drug exposures is potentially high. The objective of this study was to estimate the depressive symptoms population attributable risk percent (PAR%) in a medical inpatient population. METHODS: A prospective cohort design was used in this study. Nondepressed, nondrug-exposed subjects (N = 178) were selected from a series of 369 newly admitted medical inpatients at the Calgary General Hospital. Eighty-six of these 178 subjects were prescribed one of the drugs in question, forming an exposed cohort. The remaining subjects formed a nonexposed cohort. Depressive symptoms and associated psychosocial variables were measured in both subgroups during the hospital stay. RESULTS: Seventeen of the 86 exposed subjects and 5 of the 92 nonexposed subjects developed incident depressive symptoms during their stay in hospital. The PAR% associated with drug exposure (56.0%) exceeded that associated with poverty (17.9%) or unemployment (21.7%). CONCLUSIONS: Drug exposures may have a sizeable impact on the incidence of depressive symptoms in medical inpatient populations.

Alberta↗
PubMedDate not supplied

Analysing the workload from HIV inpatients: a 10-month retrospective study.

To assess the clinical and laboratory workload arising from human immunodeficiency virus (HIV)-related inpatient admissions in a London teaching hospital, a 10-month retrospective audit was performed of the casenotes of all HIV-infected inpatients admitted under the care of one consultant physician. During this period, 84 inpatients were identified who generated 371 admissions, of whom 71 (84.5%) had acquired immunodeficiency syndrome (AIDS). Over two-thirds of admissions were essentially day cases, attributed to blood transfusions, antimicrobial and tumour, chemotherapy, and minor surgery; with blood transfusions alone accounting for 43% of all admissions. Pulmonary infections (pyogenic and cell-mediated opportunist) accounted for 46 (12%) of admissions, with Pneumocystis carinii pneumonia second only to blood transfusions in caseload prevalence score (see below). Neurological complications of AIDS were associated with the longest admissions. Laboratory-based investigations were heavily utilized by AIDS inpatients, particularly bacteriological services. Choice of radiological investigation correlated with the anatomical site of disease presentation: plain radiology for chest symptoms, ultrasound for abdominal symptoms and computerized tomography (CT scanning) for neurological presentations. Drug-induced anaemia accounted for a substantial number of HIV-related admissions for red cell transfusions, which together with the disproportionate workload from daycase-type admissions, might be better handled in lower dependency day wards.

HIV Infections↗
PubMedDate not supplied

The inpatient advanced practice nursing roles in a Canadian pediatric oncology unit.

The role of the nurse practitioner has been long established in the outpatient setting in pediatric oncology. The inpatient nurse practitioner role has been described to a lesser extent. This review of the role of the inpatient clinical nurse specialist/nurse practitioner on the 27-bed inpatient oncology unit at the Hospital for Sick Children in Toronto, Ontario, Canada, will describe the role and strategies for its implementation. This role of the clinical nurse specialist/nurse practitioner facilitates the provision of quality care to children and families admitted to the inpatient oncology unit.

Child↗
PubMed1994

The Brief Symptom Inventory as an Outcome Measure for Adolescent Psychiatric Inpatients

The utility of the Brief Symptom Inventory (BSI) as an outcome measure for adolescent psychiatric inpatients was evaluated. The BSI was administered to 88 male and 100 female psychiatric inpatients at admission and discharge. There were statistically significant mean score changes from pretest to posttest on most BSI indices, with effect sizes ranging between small and medium. Statistical analyses produced generally equivalent results, whether T scores or raw scores were used as dependent variables. However, the ability of the BSI to detect pretest to posttest change reliably for individual patients was quite limited. The degree of symptom distress reported by adolescent inpatients, moreover, did not differ greatly from those found in normative data for adolescent non-patients. It is possible that this relative lack of discrimination between adolescent inpatients and non-patients may be associated with limitations inherent in using self-report inventories with adolescent populations.

Journal Article↗
PubMed2001

Venous thromboembolism in medical inpatients: prophylaxis with low-weight heparin in a university hospital and prevalence of thromboembolic events.

The aim of this study was to determine the prevalence of venous thromboembolism (VT) in current prophylactic practice with low-molecular-weight heparin (LMWH) among medical inpatients and to analyze associated risk factors for VT. A cross-sectional survey on five given days was conducted in the medical departments of a university hospital. The prevalence of prophylaxis and confirmed VT was measured. Risk markers for receiving high doses of LMWH and for VT under prophylaxis were assessed by logistic regression models. Of 1,194 inpatients, 1.4% suffered VT. The mean proportion of patients with LMWH prophylaxis was 24% (range: 4-64%). The prevalence of VT was higher among inpatients receiving prophylaxis than among those patients not receiving prophylaxis (3.5% vs. 0.7%, p = 0.002). Under prophylaxis, independent risk markers for thrombosis were history of vein thrombosis (odds ratio [OR]: 4.03; confidence interval [95%CI]: 1.04-15.62) and age (OR: 1.08; 95%CI: 1.01-1.15). Two factors were independently associated with the prescription of high doses of LMWH: obesity was positively associated (OR: 7.50; 95%CI: 2.97-18.92; p < 0.0001) and respiratory insufficiency was negatively associated. In medical departments, current prophylaxis practice leads to many patients being given LMWH. LMWH doses and other preventive measures should be adapted in high-risk inpatients.

Age Factors↗
PubMed2005

An economic evaluation of inpatient residential treatment programs in the Department of Veterans Affairs.

The Veterans Health Administration (VA) established psychosocial residential rehabilitation treatment programs (RTPs) to treat eligible veterans who have psychiatric and substance use disorders in a less intensive and more self-reliant inpatient setting. Forty-two (25 percent) VA medical centers adopted RTPs in 1995. Panel regression models using data from 1993 through 1999 indicated that RTPs were associated with 8.6 and 24.4 percent decreases in the average cost per day for inpatient psychiatry and substance use care, respectively. During this time, VA transitioned much of the inpatient mental health care to ambulatory services. Yet medical centers with RTPs had smaller decreases in the number of inpatient patient days than those without RTPs. Because medical centers with RTPs provided more services, this offset the per diem savings, resulting in no significant differences in total costs between medical centers with and without RPTs.

Costs and Cost Analysis↗
PubMed2001

Integration of inpatient and outpatient services in an acute care transplant unit.

Creating an ambulatory outpatient service for transplant recipients in an inpatient care unit allows several goals to be met: decreased inpatient length of stay, decreased cost per case, and increased patient satisfaction. By using 6 inpatient beds for ambulatory outpatient procedures, the leadership staff of an adult inpatient care unit in Mount Sinai Medical Center consolidated adult transplant services into a single area promoting quality transplant care.

Acute Disease↗
PubMed2000

A randomized controlled trial of the Geriatric Depression Scale in an inpatient ward for older adults.

OBJECTIVES: To measure the prevalence of high scores on the Geriatric Depression Scale in an inpatient unit for older people and assess whether administration of this instrument increased the use of antidepressant medication. DESIGN: Randomized controlled trial. SETTING: Inpatient unit for assessment, treatment and rehabilitation of older adults in a district hospital. SUBJECTS: Consecutive admissions to the inpatient unit were approached. Of 198 people, 100 gave consent and were randomized to receive the intervention. INTERVENTIONS: The Geriatric Depression Scale and the Folstein Mini-mental State Examination were administered to the intervention group. The Nottingham Instrumental Activities of Daily Living questionnaire and the Folstein Mini-mental State Examination were administered to the placebo group. The scores of these instruments and a copy of the completed instrument were placed in the subject's case notes. For those subjects randomized to receive the Geriatric Depression Scale an interpretation of the score was written in the case notes. MAIN OUTCOME MEASURES: The primary outcome measure was whether antidepressant medication was listed on the discharge summary for the admission. Other outcome measures were death, readmission and use of antidepressant medication three months after administration of the instruments. RESULTS: There was a prevalence of Geriatric Depression Scale scores greater than 10 of 52% in the 50 people administered this instrument. Six out of 46 people administered the Geriatric Depression Scale, who were discharged in the study period, were on antidepressant medication at discharge. Three out of 47 people administered the placebo instrument were on antidepressant medication at discharge. The absolute difference in proportions was 6.7%, 95% confidence interval 19 to -5.3%. CONCLUSIONS: A high proportion of patients admitted to an inpatient unit for assessment, treatment and rehabilitation scored in the depressed range on the Geriatric Depression Scale; however, use of the Geriatric Depression Scale in this clinical setting did not increase the use of antidepressant medication. This may be because the instrument is too nonspecific.

Aged↗
PubMed2006

The sensitivity of three commonly used outcome measures to detect change amongst patients receiving inpatient rehabilitation following stroke.

OBJECTIVE: To investigate the sensitivity of three commonly used functional outcome measures to detect change over time in subjects receiving inpatient rehabilitation post stroke. DESIGN: Subjects were assessed within one week of admission and one week of discharge from an inpatient rehabilitation facility. Several parameters of sensitivity were calculated, including floor and ceiling effects, the percentage of subjects showing no change and the effect size of the change between admission and discharge. SETTING: The medical rehabilitation ward of an inpatient rehabilitation facility. SUBJECTS: Seventy-eight subjects receiving inpatient rehabilitation following a first or recurrent stroke. MEASURES: Five-metre walk, comfortable pace (gait speed), the Berg Balance Scale and the Motor Assessment Scale. RESULTS: Sixty-one subjects had complete admission and discharge data. Gait speed and the Berg Balance Scale were both sensitive to change and demonstrated large effect sizes. The Motor Assessment Scale item five also showed a large effect size and was able to detect change amongst lower functioning subjects. The other items of the Motor Assessment Scale were less useful, in particular, the effect sizes for upper extremity change scores were small (d=0.36-0.5) and the majority of subjects (44.3-63.9%) showed no change over time on these measures. CONCLUSION: Gait speed, the Berg Balance Scale and the Motor Assessment Scale item five were sensitive to change over time in this sample.

Aged↗
PubMed2004

A survey of the perspectives of specialist palliative care providers in the UK of inpatient respite.

One of the major reasons for admission of patients to hospital in late stage disease is the inability of carers to continue to provide care at home. Specialist palliative care services have typically admitted patients for acute symptom control, terminal care and respite care to benefit them and their carers. This paper reports the results of a cross-sectional survey of inpatient respite care provision provided by specialist palliative care services and hospices in the UK. A structured questionnaire was mailed to 242 clinical services managers listed in the Hospice Information Directory in 2003. A 69% response rate was achieved. The questionnaire explored the nature of respite services, their purpose, organization, delivery and examined definitions used. The analysis indicated that 80% of the sample provided inpatient respite care. Most inpatient respite admissions were planned, of fixed duration (7-14 days) and were intended to benefit patients and carers. There was some evidence that respite provision was regarded as a lower priority than admissions for symptom control and terminal care, and that patients' needs were prioritized over those of carers. Only 10% of services conducted regular, routine audit, with very few seeking the views of service users. Findings suggest that carers' needs and wishes are not prioritized by specialist palliative care services offering inpatient respite, which may mean that they find it difficult to maintain their caregiving roles over longer disease trajectories or in the face of overwhelming demands.

Caregivers↗
PubMed2004

Inpatient versus outpatient management of low-risk pediatric febrile neutropenia: measuring parents' and healthcare professionals' preferences.

PURPOSE: Our primary objective was to describe and compare parents' and healthcare professionals' strength of preference scores for outpatient oral antibiotic relative to inpatient parenteral antibiotic treatment for low-risk febrile neutropenic children. Our secondary objective was to identify predictors of strength of preference for oral outpatient treatment. METHODS: Respondents were parents of children receiving cancer chemotherapy, and pediatric oncology healthcare professionals. First, the inpatient and outpatient options were described, and the respondent indicated their initially preferred option. The respondent next ranked how important seven factors (including "fear/anxiety" and "comfort") were in making their initial choice. The threshold technique was then used to elicit the respondent's strength of preference score for oral outpatient, relative to parenteral inpatient management. RESULTS: There were 75 parent and 42 healthcare-professional respondents. There was no significant difference (P =.08) in the proportions of parents (40 of 75; 53%) and healthcare professionals (30 of 42; 71%) who initially would choose outpatient management. For parents, stronger preference for oral outpatient therapy was associated with higher anticipated quality of life for the parent and child at home relative to hospital, lower importance rank for "fear/anxiety," and higher importance rank for "comfort." Conversely, for professionals, only lower importance rank for "fear/anxiety" was associated with higher strength of preference scores for outpatient oral antibiotic management. CONCLUSION: Only 53% of parents would choose outpatient oral antibiotic management for low-risk febrile neutropenia. Predictors of strength of preference scores for outpatient oral antibiotic relative to inpatient parenteral antibiotic treatment differed between parent and professional respondents.

Administration, Oral↗
PubMed1994

Emotional distress in adolescent psychiatric inpatients: direct and indirect measures.

This study examined whether adolescent male psychiatric inpatients were less likely than comparable female inpatients to communicate their feelings on direct measures of emotional distress. Ninety-one adolescent psychiatric inpatients were assessed using the Rorschach, the Minnesota Multiphasic Personality Inventory, and other measures of emotional distress. In general, male and female subjects reported highly similar levels and patterns of distress whether direct or indirect measures were used. Although the direct measures showed evidence of convergent validity, the indirect measures were largely uncorrelated with each other and with the direct measures. These results suggest that the assessment of emotional distress in both male and female adolescent inpatients is best facilitated by the use of direct measures.

Adolescent↗
PubMed1996

MMPI differences among adolescent inpatients, rapists, sodomists, and sexual abusers.

This study examined Minnesota Multiphasic Personality Inventory (MMPI) responding among 61 adolescent sex offenders accused of Sexual Abuse (n = 22), Rape (n = 19), and Sodomy (n = 18) and 15 adolescents without a history of sexual offending admitted to an inpatient psychiatric unit. Results indicated significant differences between sex offenders and inpatients as well as among sex offender groups on both single-scale elevations and 2-point code types. Contrary to previous research, adolescents in the sex offender groups demonstrated significantly more psychopathology than those in the inpatient sample. Subjects in the Sodomy group achieved the highest clinical scale elevations and were more likely to have scales associated with significant psychopathology as one of their 2-point pairs. In general, increased psychopathology was associated with increased sexual deviancy. That is, subjects in the sexual offender groups evidenced more psychopathology than inpatients and the more deviant Sodomy and Rape groups evidenced more psychological disturbance on the MMPI than Sexual Abuser subjects. Results indicate that the MMPI can be useful in providing both quantitative and qualitative distinctions among adolescent sex offenders.

Adolescent↗
PubMed1993

Dose-response study of oral famotidine for reduction of gastric acidity and volume in outpatients and inpatients.

A relatively new H2-antagonist, famotidine, has become clinically available, but its effectiveness in decreasing gastric acidity and volume has not been compared in inpatients and outpatients. We reexamined the difference in gastric acidity and volume in inpatients and outpatients, and tested the effectiveness of different oral doses and dosage regimens of famotidine in reducing gastric acidity and volume in both groups of patients. Patients received either placebo or 20 mg or 40 mg of famotidine orally the night before surgery (HS) and on the morning of surgery (AM). One hundred forty-two inpatients and 180 outpatients were randomized to one of seven groups as follows: 1) placebo (HS)/placebo (AM); 2) 20 mg of famotidine (HS)/20 mg of famotidine (AM); 3) 20 mg of famotidine (HS)/placebo (AM); 4) placebo (HS)/20 mg of famotidine (AM); 5) 40 mg of famotidine (HS)/40 mg of famotidine (AM); 6) 40 mg of famotidine (HS)/placebo (AM); and 7) placebo (HS)/40 mg of famotidine (AM). We measured the gastric acidity and volume after induction of anesthesia and found no difference between the inpatients and outpatients, with or without famotidine. We found that famotidine given HS and AM or AM only was effective in reducing gastric acidity in both groups of patients, and that there was no difference between the 20-mg and 40-mg doses of famotidine. Gastric volume was not affected by any famotidine dose.

Administration, Oral↗
PubMedDate not supplied

Is inpatient rehabilitation of the alcoholic cost effective? Con position.

Across all sectors of the health care system there is pressure to increase the cost-effectiveness of service delivery. In recent years, a number of official reports in the alcoholism field have called for the establishment of alternatives to traditional inpatient hospitalization for alcoholics. This paper briefly reviews five bodies of scientific evidence that bear on this recommendation. It is concluded that: inhospital alcoholism programmes of a few weeks to a few months duration show no higher success rates than periods of brief hospitalization of a few days; the great majority of alcoholics seeking treatment for alcohol withdrawal can be safely detoxified without pharmacotherapy and in nonhospital-based units--detoxification with pharmacotherapy on an ambulatory basis has also been shown to be a safe alternative at one-tenth the cost; "partial hospitalization" (day treatment) programmes have been found to have equal or superior results to inpatient hospitalization at one-half to one-third the cost; well-controlled trials have also demonstrated that outpatient programmes can produce comparable results to inpatient programmes--one estimate places the cost saving at $3700 per patient compared with the typical course of inpatient treatment; and a growing body of evidence suggests that if patients could be matched on clinically significant dimensions to a range of treatment alternatives, much higher overall improvement rates in the alcoholism treatment field would be observed. The question that should guide future investigation is "What treatments are most effective for what types of alcoholics?"

Alcoholism↗
PubMed2005

[Personality disorders after inpatient psychodynamic psychotherapy].

OBJECTIVES: The following paper presents the results of a post-treatment examination on inpatients with personality disorders who received psychodynamic psychotherapy. The examination was carried out approximately 3.3 years after the patients were discharged. METHODS: Of a group of 110 patients with personality disorders (ICD-10), 72 patients underwent follow-up examination. A comprehensive catamnesis was compiled for 59 former patients; 13 former patients answered by post. Treatment success was evaluated on the basis of the Symptom Checklist 90-R, Inventory of Interpersonal Problems and Questionnaire of Social Support. These surveys show no significant statistical difference between the data of the subgroups of participants and non-participants of the post-treatment examination at the start and end of therapy (Mann-Whitney-U-Test, p > 0.05). Treatment success was also examined using the Global Assessment of Functioning Scale, the Impairment-Score as well as an analysis of the patient's use of psychiatric and inpatient psychotherapeutic care and the medication received. RESULTS: Due to the reduction in general mental stress and interpersonal problems, and the increase in perceived social support, the patients showed a positive development. After being discharged 41% of the patients received outpatient psychotherapy without further psychiatric and inpatient psychotherapeutic care. CONCLUSIONS: The above results demonstrate that patients with personality disorders benefit from inpatient psychodynamic psychotherapy.

Adult↗
PubMedDate not supplied

Developing a Medicare prospective payment system for inpatient psychiatric care.

Under the Balanced Budget Refinement Act (BBRA) of 1999, the secretary of health and human services was mandated to implement a prospective payment system (PPS) for psychiatric inpatient facilities that were exempt from the Medicare inpatient PPS. This paper reviews the reason for the initial "distinct-part" exemption, describes research that has been conducted to inform the development of a psychiatric inpatient PPS, and examines some of the issues that must be addressed as a PPS is designed. In addition, some changes in the overall inpatient psychiatric hospital sector are discussed.

Aged↗
PubMed2003

Prioritizing strategies for preventing medication errors and adverse drug events in pediatric inpatients.

OBJECTIVES: Medication errors in pediatric inpatients occur at similar rates as in adults but have 3 times the potential to cause harm. Error prevention strategies in this setting remain largely untested. The objective of this study was to classify the major types of medication errors in pediatric inpatients and to determine which strategies might most effectively prevent them. METHODS: A prospective cohort study was conducted of 1020 patients who were admitted to 2 academic medical centers during a 6-week period in April and May 1999. Medication errors were characterized by subtype. Physician raters evaluated error prevention strategies and identified those that might be most effective in preventing errors. RESULTS: Of 10 778 medication orders reviewed, 616 contained errors. Of these, 120 (19.5%) were classified as potentially harmful, including 115 potential adverse drug events (18.7%) and 5 preventable adverse drug events (0.8%). Most errors occurred at the ordering stage (74%) and involved errors in dosing (28%), route (18%), or frequency (9%). Three interventions might have prevented most potentially harmful errors: 1) computerized physician order entry with clinical decision support systems (76%); 2) ward-based clinical pharmacists (81%); and 3) improved communication among physicians, nurses, and pharmacists (86%). Interrater reliability of error prevention strategy assignment was good (agreement: 0.92; kappa: 0.82). CONCLUSIONS: Of the assessed interventions, computerized physician order entry with clinical decision support systems; ward-based clinical pharmacists; and improved communication among physicians, nurses, and pharmacists had the greatest potential to reduce medication errors in pediatric inpatients. Development, implementation, and assessment of such interventions in the pediatric inpatient setting are needed.

Adult↗