Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Program Efficiency”

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 937 records · Page 52Linked to original sources

Nurse-intern programs: how they're working.

Results of the study support conclusions drawn from the literature: The nurse-intern program stands as an efficient, effective method of orienting new graduate nurses in their first work experience. Internships provide a highly realistic vehicle for smoothing the transition from student to staff nurse and also promote recruitment and retention of qualified personnel. Participation in an intern program helps the graduate assume increasingly responsible roles as he or she gains self-confidence, competence, and comfort in the clinical setting and becomes more able to give quality patient care. Strong similarities among programs as noted in both the study and the literature suggest that despite differences in titles and settings for these programs, many commonalities do exist. A common feature seems to be the placement of a limited number of participants in one or two areas for a lengthy period under the guidance of a specified individual. This overall structure, in conjunction with a well-developed plan of program objectives and experiences, appears to constitute the formula for success. Agencies considering development of a nurse-intern program would do well to first consider their ultimate goal in establishing such a program. Realistic assessment of the agency's capabilities and resources in relation to this desired end will help set the tone for subsequent program planning and minimize future frustration. For a program of this type, support from all levels of administration is essential, since the hoped-for return on investment may be some time in coming.

Education, Nursing, Baccalaureate↗

Postgenomic bioinformatic analysis of yeast artificial chromosome sequence.

The free availability of multiple genomic sequences represents one of the greatest advances in biology of the new millennium, and promises to revolutionize our ability to determine and treat the causes of human disease. This chapter highlights a number of basic, freely available, and user-friendly bioinformatic techniques that can be used to predict the functional genetic contents of specific yeast artificial chromosome (YAC) clones. The content of this chapter is written for the level of graduate students, who may be relatively inexperienced with the use of computers for analyzing DNA sequences. The basic instructions that allow the identification of the genomic sequence of interest and to download this sequence onto a personal computer from an online database are presented. Simple instructions are also given on how to perform basic sequence manipulations, how to use online tools to design polymerase chain reaction primers, and how to map restriction sites. Also described are more complicated programs that rapidly and efficiently perform genome alignments that, in addition to predicting the location of protein coding sequences, allow the prediction of functional genomic sequences, such as cis regulatory elements and scaffold/matrix attachment sites. The availability of genomic sequences and the rapidly expanding numbers of predictive programs that allow the predictive analysis of these sequences promises to greatly facilitate the use of YAC clones in the search for the causes of disease.

Chromosomes, Artificial, Yeast↗

A cost analysis of a smoke alarm installation and fire safety education program.

INTRODUCTION: While smoke alarm installation programs can help prevent residential fire injuries, the costs of running these programs are not well understood. METHOD: We conducted a retrospective cost analysis of a smoke alarm installation program in 12 funded communities across four states. Costs included financial and economic resources needed for training, canvassing, installing, and following-up, within four cost categories: (a) personnel, (b) transportation, (c) facility, and (d) supplies. RESULTS: Local cost per completed home visit averaged 214.54 dollars, with an average local cost per alarm installed of 115.02 dollars. Combined state and local cost per alarm installed across all four states averaged 132.15 dollars. For every 1% increase in alarm installation, costs per alarm decrease by 1.32 dollars. CONCLUSIONS: As more smoke alarms are installed, the average installation cost per alarm decreases. By demonstrating effective economies of scale, this study suggests that smoke alarm programs can be implemented efficiently and receive positive economic returns on investment.

Accident Prevention↗

Evaluation of emergency department referrals by telephone triage.

OBJECTIVE: Telephone triage programs are becoming very common at children's hospitals across the nation. One of the proposed benefits of these programs is the more efficient use of health care resources by triaging patients to the appropriate level of health care. The purpose of this study is to examine the appropriateness of referrals to a pediatric emergency department (ED) by the Pediatric Health Information Line (PHIL), a hospital-based telephone triage program, versus all other sources of referrals. METHODS: A blinded Delphi rating system was used to review the physician's sheets of 133 consecutive ED referrals by PHIL for medical appropriateness. A total of 260 randomly selected control patients seen in the ED during the same period were similarly reviewed. If 2 of 3 pediatric emergency medicine physicians agreed that an ED visit was appropriate, then it was considered appropriate. A comparison of the 2 groups' ED appropriateness was made using a contingency table chi(2) test. An odds ratio with confidence limits was also calculated. Demographic data were collected for both groups including age, race, gender, and insurance status. RESULTS: The PHIL group had an appropriateness rate of 80.2%, compared with 60.5% for the control group (chi(2) = 14.6369; odds ratio = 2.65; 95% confidence interval [1.5759,4.5008]). CONCLUSIONS: This demonstrated that for the period studied, PHIL referrals to the ED had a 33% higher rate of appropriateness than controls. This evidence supports telephone triage as an efficient gatekeeper for health care resources.

Alabama↗

Comparison of two leukapheresis programs for computerized collection of blood progenitor cells on a new cell separator.

BACKGROUND: Peripheral blood progenitor cells (PBPCs) can be collected on various cell separators. Two leukapheresis programs (LP-MNC and LP-PBSC-Lym) were evaluated for computerized collection of PBPCs on a new cell separator. STUDY DESIGN AND METHODS: Leukapheresis assisted by the LP-MNC or LP-PBSC-Lym software was performed for the harvesting of PBPCs in 52 oncology patients after chemotherapy plus G-CSF treatment and in 18 healthy subjects after G-CSF mobilization alone. RESULTS: A total of 38 components from 33 donors via LP-MNC and 43 components from 37 donors via LP-PBSC-Lym were collected with a median of one (range, one to two) standard-volume leukapheresis procedures (9.2-13.3 L) per donor. There were no significant differences between the two groups concerning median counts of WBCs, CD34+ cells, CD34+ cell yields per harvest, and CD34+ cell yields of cumulative harvests. The blood cell counts after leukapheresis revealed that the LP-MNC resulted in significantly higher platelet loss than LP-PBSC-Lym (p = 0.024): 35.9 percent (range, 19.2%-66.1%) versus 29.7 percent (11.6%-52.3%). Regarding the CD34+ cell collection efficiency, the LP-MNC program was significantly better than the LP-PBSC-Lym program (p < 0.001): 77.5 percent (range, 35.5%-98.9%) versus 58.3 percent (range, 20.4%-98.9%). However, concentrates collected by the LP-PBSC-Lym program had significantly higher percentages of MNCs (p < 0.001) and CD34+ cells (p = 0.028) than harvests with the LP-MNC program: 90 percent (range, 69%-99%) versus 70 percent (range, 35%-98%) and 1.2 percent (range, 0.2%-7.3%) versus 0.7 percent (range, 0.2%-6.0%), respectively. No leukapheresis-related serious adverse events were seen, and time for hematopoietic engraftment was equivalent to data published in the literature. CONCLUSION: The LP-MNC program shows a significantly better CD34+ cell collection efficiency than the LP-PBSC-Lym program. However, collections with the LP-MNC program result in PBPC components with a lower MNC and CD34+ cell concentrations and a higher apheresis-related loss of patient's platelets.

Antigens, CD34↗

Re-engineering: an opportunity to advance clinical practice in a community hospital.

A hospital pharmacy's efforts to advance clinical pharmacy practice and reduce pharmacy costs as part of a hospitalwide re-engineering program are described. In 1995, a 321-bed community hospital in Wisconsin undertook a three-year re-engineering program aimed at reducing operating expenses, primarily labor costs. The pharmacy department focused its efforts within the program on improving the efficiency of product-related functions, mainly through automation, and redeploying staff to value-added clinical functions. This involved installation of a hospitalwide pneumatic-tube system, use of unit-based automated medication dispensing devices, and implementation of a dedicated clinical pharmacy services program. Implementation of this program was to occur incrementally, with the first 12 months to be used primarily in developing a service model, initiating a staff-development program, and hiring additional clinical staff. Services added under the program included i.v. to oral conversion, dosage adjustments for patients with renal impairment, advanced patient counseling, development of care plans, and rounds in all areas of the hospital. After the first full year of implementation of the program, a cost-benefit analysis was undertaken; costs were composed primarily of pharmacists' salaries and benefits, and benefits were composed primarily of drug cost savings. A benefit to cost ratio of 2.61:1 and a net saving of $217,551 were calculated. The introduction of clinical pharmacy services as part of a hospitalwide re-engineering program was associated with a positive benefit to cost ratio and a substantial net cost saving.

Cost-Benefit Analysis↗

Is it quality assurance or quality improvement; and what is it?

The term quality has a different meaning for everyone. Persons seeking health care have predetermined expectations that the care they receive is efficient, effective, and meets their needs. Through nursing quality improvement programs, nurses themselves can evaluate the efficiency of the care they provide. Through the use of patient surveys, nurses become aware of the patient's needs and degree of satisfaction. Monitor tools based on nursing standards and policies are used to assess the components of care. A successful nursing quality improvement program requires a climate that educates, supports, and encourages staff involvement.

Humans↗

[The effects of inhalation of essential oils on the body weight, food efficiency rate and serum leptin of growing SD rats].

PURPOSES: This experimental study was designed to verify the effect of inhalation of essential oils on body weight, feed intake, food efficiency rate and serum leptin. METHODS: The subjects of this study were 90 growing SD rats (46 males and 44 females). They were allocated into one of four groups, the Fennel group, Patchouli group, Bergamot group and control group. The experimental treatment was the inhalation of aromatherapy essential oils which was applied two times a day for 10 minutes each during 8 weeks. To evaluate the effects, body weight, feed intake, food efficiency rate and serum leptin were measured before and after the treatment. The collected data was analyzed by repeated measures of Kolmogorov-smirnov test and Normal Q-Q plot for normality, Kruskal Wallis test and chi2-test for experimental effects with the SPSS program. RESULTS: The food efficiency rate was significantly lower in the Patchouli group and Fennel group than in the Bergamot group and control group (P=.000). No significant group effects were found for SD rat's body weight, feeding amount and serum leptin. CONCLUSION: In conclusion, these findings indicate that the inhalation of essential oils could be effective in lowering the food efficiency rate rather than the feed intake.

Administration, Inhalation↗

Results of a pediatric sedation program on head MRI scan success rates and procedure duration times.

The purpose of this study was to determine if a pediatric sedation program improved head magnetic resonance imaging (MRI) scan success rates and procedure duration times compared with the year preceding the program. Sedation was successful in 189 (85.1%) of 222 children before the program compared with 211 (98.1%) of 215 children during the program (P < 0.001). Mean procedure duration times for head MRI scans with and without contrast were shorter in the program compared with before the program (58.7 +/- 1.4 min versus 71.8 +/- 3.0 min, P < 0.001, and 46.7 +/- 1.2 min versus 58.5 +/- 1.9 minutes, P < 0.001, respectively). No major complications occurred during the 15-month period in the sedation program. We conclude that sedation for pediatric MRI, managed by an organized pediatric sedation program, is highly successful, efficient, and safe.

Ambulatory Care↗

Influence of general self-efficacy on the effects of a school-based universal primary prevention program of depressive symptoms in adolescents: a randomized and controlled follow-up study.

BACKGROUND: Depressive disorders in adolescents are a widespread and increasing problem. Prevention seems a promising and feasible approach. METHODS: We designed a cognitive-behavioral school-based universal primary prevention program and followed 347 eighth-grade students participating in a randomized controlled trial for three months. RESULTS: In line with our hypothesis, participants in the prevention program remained on a low level of depressive symptoms, having strong social networks. The control group showed increasing depressive symptoms and a reduced social network. Contrary to our expectations, students low in self-efficacy benefited more from the program than high self-efficient students. Social network did not mediate the relationship between participation in the prevention program and changes in depressive symptoms. CONCLUSIONS: Our results show that the prevention program had favorable effects. Further research is needed to explore the impact of self-efficacy on the effects of prevention programs.

Adolescent↗

HIPAA administrative simplification: standard unique health identifier for health care providers. Final rule.

This final rule establishes the standard for a unique health identifier for health care providers for use in the health care system and announces the adoption of the National Provider Identifier (NPI) as that standard. It also establishes the implementation specifications for obtaining and using the standard unique health identifier for health care providers. The implementation specifications set the requirements that must be met by "covered entities": Health plans, health care clearinghouses, and those health care providers who transmit any health information in electronic form in connection with a transaction for which the Secretary has adopted a standard (known as "covered health care providers"). Covered entities must use the identifier in connection with standard transactions. The use of the NPI will improve the Medicare and Medicaid programs, and other Federal health programs and private health programs, and the effectiveness and efficiency of the health care industry in general, by simplifying the administration of the health care system and enabling the efficient electronic transmission of certain health information. This final rule implements some of the requirements of the Administrative Simplification subtitle F of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Centers for Medicare and Medicaid Services, U.S.↗

Neonatal thyroid screening: methods-efficiency-failures.

Newborn screening for congenital hypothyroidism (CH) is one of the major achievements of preventive medicine, as the condition occurs frequently (1/4000 newborns) and results in brain damage if not detected and treated in the first few days of life. Measurement of T4 and/or TSH in dried blood spots collected on the second through fifth days of life are the most widely used methods in screening programs for CH currently. Some children with the disease may be missd in any screening program, however, owing to factors related to the disease itself and the methods employed in its detection, as well as factors ascribed to the element of human error, ie screening errors. The methods employed in newborn screening programs for CH, their efficiency in disease detecetion, and biological factors as well as screening errors leading to missed cases are discussed.

Biomarkers↗

Matching substance abuse patients to appropriate treatments: a conceptual and methodological approach.

The paper describes a non-intrusive, computer assisted, program evaluation design for matching sub-types of substance abuse patients to appropriate treatment programs in any multi-modal treatment network. The design incorporates the methodological advantages of an experimental paradigm without the administrative and clinical problems of random patient assignment, and untreated control groups. The specific objectives of this design are: (1) The development of a generalizable evaluation process to efficiently match patients with programs. (2) An overall increase in treatment success through improvement of treatment assignment procedures. (3) A general improvement in cost-effectiveness through reductions in patient drop-out, recidivism, and treatment overlap.

Computers↗

Newborn screening in Korea.

The Ministry of Health and Social Affairs adopted a newborn screening program in 1991 to cover low-income families. The system was extended in 1997 to cover all newborns. The number of screened conditions was reduced from 6 (CH, PKU, Gal, MSUD, HU, HIS) to 2 (CH, PKU) in 1995. The national newborn screening program was in need of an in-depth review for further improvement. Thus, a background survey was conducted at 241 health centers in June 2000 to assess the current status of the screening system and to identify characteristics of detected patients. Expert opinions on the effect and efficiency of the screening program were also gathered. The number of identified cases was 481--CH (378 cases), PKU (73), MSUD (11), PA (7), UCD (9) and Gal (3). Most cases were identified after 1997. Of all cases, 83.5% were identified within 2 months after birth; discovery rate within 2 months after birth increased rapidly from 23.5% in 1994 to 90% in 1997; 17.7% of PKU and 4.2% of CH cases had associated family histories. Among the problems the present study revealed are: absence of an organization responsible for coordination and control of national newborn screening services, too many screening laboratories (76 laboratories as of 2000), inadequate follow-up treatments and services, complicated remuneration system. Further services; reduce the number of screening laboratories from the current 76 to 3-4 laboratories; mplement Tandem Mass Screening; and simplify the remuneration system.

Health Care Surveys↗

E-conferencing for delivery of residency didactics.

OBJECTIVE: While didactic conferences are an important component of residency training, delivering them efficiently is a challenge for many programs, especially when residents are located in multiple sites, as they are at Wayne State University School of Medicine in the Department of Family Medicine. Our residents find it difficult to travel from our hospitals or rotation sites to a centralized location for conferences. In order to overcome this barrier, we implemented distance learning and electronically delivered the conferences to the residents. DESCRIPTION: We introduced an Internet-delivered, group-learning interactive conference model in which the lecturer is in one location with a group of residents and additional residents are in multiple locations. We launched the project in July 2001 using external company meeting services to schedule, coordinate, support, and archive the conferences. Equipment needed in each location consisted of a computer with an Internet connection, a telephone line, and a LCD projector (a computer monitor sufficed for small groups). We purposely chose simple distance-learning technology and used widely available equipment. Our e-conferencing had two components: (1) audio transmission via telephone connection and (2) visual transmission of PowerPoint presentations via the Internet. The telephone connection was open to all users, allowing residents to ask questions or make comments. Residents chose a conference location depending on geographic proximity to their rotation locations. Although we could accommodate up to 50 sites, we focused on a small number of locations in order to facilitate interaction among residents and faculty. Each conference session is archived and stored on the server for one week so those residents whose other residency-related responsibilities precluded attendance can view any conferences they have missed. DISCUSSION: E-conferencing proved to be an effective method of delivering didactics in our residency program. Its many advantages included ease of use, cost-efficiency, and wide availability of equipment. Residents had the advantage of both geographic and temporal independence. Our e-conferences were interactive, and in addition to a PowerPoint presentation, faculty provided Web sites and hyperlinks for references. Initial problems included slow-speed connection, the requirement for digital materials, and the need for residents and faculty to adjust to a new learning method. There was also a need for increased coordination at the sites and reliance on electronic communication. To assess the effectiveness of the program, residents completed knowledge pre- and post-tests and a conference evaluation form. We also monitored conference attendance rates. Preliminary results indicated positive resident attitudes toward distance learning and significant increases in conference attendance. To objectively evaluate this instructional delivery method, we will compare residents' knowledge gains in the face-to-face instructor group with those of the group to which the lecture is broadcast. Ultimately, we are hoping to offer this educational opportunity to other family practice residency programs in the area, to medical students interested in family medicine, and to community family physicians for continuing medical education. We are considering the addition of streaming video to the presentations in the future, once the bandwidth of the Internet connections is sufficient.

Congresses as Topic↗

Assessment of efficient sampling designs for urban stormwater monitoring.

Monitoring programs for urban runoff have not been assessed for effectiveness or efficiency in estimating mass emissions. In order to determine appropriate designs for stormwater, total suspended solids (TSS) and flow information from the Santa Ana River was collected nearly every 15 min for every storm of the 1998 water year. All samples were used to calculate the "true load" and then three within-storm sampling designs (flow-interval, time-interval, and simple random) and five among-storm sampling designs (stratified by size, stratified by season, simple random, simple random of medium and large storms, and the first m storms of the season) were simulated. Using these designs, we evaluated three estimators for storm mass emissions (mean, volume-weighted, and ratio) and three estimators for annual mass emissions (median, ratio, and regular). Designs and estimators were evaluated with respect to accuracy and precision. The optimal strategy was used to determine the appropriate number of storms to sample annually based upon confidence interval width for estimates of annual mass emissions and concentration. The amount of detectable trend in mass emissions and concentration was determined for sample sizes 3 and 7. Single storms were most efficiently characterized (small bias and standard error) by taking 12 samples following a flow-interval schedule and using a volume-weighted estimator of mass emissions. The ratio estimator, when coupled with the simple random sample of medium and large storms within a season, most accurately estimated concentration and mass emissions; and had low bias over all of the designs. Sampling seven storms is the most efficient method for attaining small confidence interval width for annual concentration. Sampling three storms per year allows a 20% trend to be detected in mass emissions or concentration over five years. These results are decreased by 10% by sampling seven storms per year.

Environmental Monitoring↗

High resolution genetic map of the adenomatous polyposis coli gene (APC) region.

Familial adenomatous polyposis coli (APC) is a dominantly inherited colorectal cancer susceptibility disease caused by mutation in a gene called APC and located on chromosome 5q21. Presymptomatic diagnosis of this condition is recommended because it enables restriction of the efficient but demanding prevention program to those relatives that are genetically affected. The large size of the APC gene makes the direct search for the causal alteration difficult to implement in routine diagnostic laboratories. Because APC appears to be genetically homogeneous with alteration in a single locus causing the disease, cosegregation analysis may represent an alternative efficient method for presymptomatic diagnosis. However, the reliability of the risk estimation by linkage analysis in APC families is hampered by the lack of a short range genetic map of the APC locus. A combined approach including genotyping of 65 APC families, analysis of the CEPH database, and complementary typing of both APC and CEPH families has made it possible to derive the following genetic map: Centromere-[D5S82-D5S49]-0.02-D5S122-0.01-D5S136 -0.01-D5S135-0.02-[APC-D5S346-MCC]-0.04-[D5S81-D5S6 4]-Telomere. This order, which differs from previously proposed genetic maps, is fully compatible with recent physical mapping data. These data should contribute to increase the reliability of the presymptomatic test for APC.

Adenomatous Polyposis Coli↗