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At least 1,117 records · Page 62Linked to original sources
PubMed2004

Nursing home quality and pressure ulcer prevention and management practices.

OBJECTIVES: To measure pressure ulcer quality indicator (QI) scores and to describe the self-reported skin integrity assessment, pressure ulcer risk assessment, and pressure ulcer prevention and treatment practices in long-term care facilities (LTCFs). DESIGN: Retrospective analysis of a large data set and comparative survey. SETTING: LTCFs in Missouri. PARTICIPANTS: Three hundred sixty-two LTCFs participated in the survey. Three hundred twenty-one facilities had pressure ulcer QI scores between April 1 and September 30, 1999. MEASUREMENTS: Pressure ulcer QI scores, Pressure Ulcer Prevention & Treatment Practices Survey. RESULTS: The mean+/-standard deviation pressure ulcer QI score was 10.9+/-6.2%, with a risk-adjusted score of 15.7+/-8.9% for high-risk residents and 3.1+/-3.6% for low-risk residents. Minimizing head-of-bed elevation to less than 30 degrees was used by fewer than 20% of facilities. More than 40% of facilities used a risk assessment tool that was not evidence based. Fewer than 13% of facilities used the Agency for Health Care Policy and Research pressure ulcer prevention and treatment guidelines. No relationship was found between the number of prevention strategies (P=.892) or the number of treatment strategies (P=.921) and the pressure ulcer QI scores. CONCLUSION: Valid and reliable pressure ulcer risk assessment tools are seriously underused. Evidence-based pressure ulcer prevention and treatment guidelines appear to be rarely implemented. This study provides a basis for developing educational and quality improvement programs and future research related to pressure ulcer prevention and treatment in LTCFs.

Aged↗
PubMed1999

Legal issues: office management practices.

Student health records, whether paper or electronic, are restricted and protected to a greater degree than are educational records. Some school health office software is designed to provide greater data protection than is possible in paper records. However, unless basic district and health office practices are established to prevent access to or corruption of electronic health data, technological safeguards will be useless. This article describes school and health office policies and practices that are necessary for the integrity, confidentiality, and security of student health information.

Child↗
PubMed2000

[Acute rhinosinusitis in the adult: national survey of general practice management].

Between the 17/1/2000 and the 31/3/2000 a study was carried out in 5000 general practitioners in the management of patients with acute maxillary sinusitis. The general practitioners filled out a questionnaire in 2 parts: the first part about their management (diagnosis-treatment) and the second part included 1 case study. According to the results of the first part, acute maxillary sinusitis occurred frequently during the winter months adding further complications. The second part of the study confirmed the finding of the first part. Analysis of case study demonstrates that this pathology affected men at the median age 37.6. The incidence of bilateral sinusitis is (61.4%) maxillary (61.1%), frontal (31.7%), ethmoidomaxillary (9.4%) or sphenoidal (1.7%). One quarter of patients participated in further medical investigations that included regular X rays of sinus and 14% patients in anterior rhinoscopy. In the older patients, on the patients with unilateral sinusitis, or sphenoidal sinusitis, the investigations were more frequent and these patients appealed for the specialist frequently (Ear Nose and Throat specialist mainly). The first line of treatment included 3.2 products of which antibiotics 98.5%, vasoconstrictors 55%, anti-inflammatory 55% (corticosteroids 46.8%, non corticosteroids 8.7%), mucolytics 41.6%. In total, general practitioners confirmed their pragmatic management in the treatment of acute sinusitis based on clinical diagnosis.

Acute Disease↗
PubMed2001

Anemia management practices in peritoneal dialysis patients. Case study of the anemic patient.

The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative recommends a target hemoglobin (Hb) level of 11 to 12 g/dL (hematocrit [Hct] of 33% to 36%) for both peritoneal dialysis and hemodialysis patients. However, national tracking data indicate that peritoneal dialysis patients have consistently lower Hb/Hct levels. This article focuses on anemia management challenges that are unique to the peritoneal dialysis population. Nursing knowledge and management of Epoetin alfa dosing and administration techniques, peritonitis and other infections, and iron supplementation may help improve anemia-related outcomes in peritoneal dialysis patients.

Adult↗
PubMed2002

[Practical management of nutritional and food problems in crisis situations].

This article deals with one of the most consistent problems arising during crisis situations, i.e., food shortage. The author first presents the international context conducive to natural or man-made famine. He emphasizes the importance of early detection and the need for an evaluation phase using public health survey skills to determine the objectives of relief. He then describes strategies for management of alimentary and nutritional requirements in famine-stricken populations in function of the different types of malnutrition encountered. The article ends with a presentation of preventive measures that must be implemented in association with crisis management.

Adult↗
PubMed2000

Development of a nursing management practice atlas. Part 2, Variation in use of nursing and financial resources.

Developing mechanisms for making benchmark comparisons among hospital organization is a challenge that has been embraced by nurse executives. A methodologic approach for ensuring data congruency when using available secondary data bases for making benchmark comparisons was detailed in part one (July/August) of this two-part series. This second article analyzes nursing management data using a set of nursing and financial resource variables identified by senior nurse executives of the hospital sites involved in this study.

Benchmarking↗
PubMed2004

Innovative environmental education contributes to improved management practices in the Mid-Atlantic region of the United States.

The Mid-Atlantic Integrated Assessment (MAIA) and its partner, University of Maryland, Baltimore County (UMBC) have developed a graduate-level course focused on successful application of science by decision-makers to address a particular problem. Students conduct a literature review, interview the decision-makers and scientists, and synthesize and document the management problem, the science that was applied to that problem, and other issues that might constrain or drive the solution (e.g., legalities, social pressures, expense, politics, personalities, etc.). Students also quantify the results, evaluate who the intended audience is and how they most appropriately target them, and determine if there are other management problems that could be addressed with the science. The final products are short publications geared towards other decision-makers who might have a similar problem and might be seeking successful innovative solutions. MAIA is distributing these short publications to decision-makers throughout the Mid-Atlantic Region. The publications have been very positively received by state and local governments and watershed groups.

Conservation of Natural Resources↗
PubMedDate not supplied

[Review of 408 cases of prostatism syndrome. Have the new classifications improved its practical management?].

To the variety of symptoms known as prostatism, ultrasound, flowmetry, PSA and other complementary testing has been added over the last few years in an attempt to define it better. Also, several score tables such IPSS have been used to grade more objectively each symptom. It remains to be seen, however, whether all this is really useful to define a specific treatment in the clinical practice. To this end, we intend to analyze our own series taking advantage of a table of symptoms routinely used for years, together with the patient's own perception of his quality of life, checking which factors have more influence on the latter. We believe that the use of different overall scores in the usual practice is not effective, although they could be added to the patient's evaluation since they seem a good tool to establish comparisons between different communities.

Aged↗
PubMed1999

Identification of quality management practices to reduce the incidence of retail beef tenderness problems: development and evaluation of a prototype quality system to produce tender beef.

A prototype quality system for ensuring beef tenderness was designed and tested. The test population of cattle was genetically diverse, but it was constrained to include youthful (14- to 17-mo-old) steers with no more than 3/8 Bos indicus inheritance. Feeding and preharvest management of the cattle were consistent with procedures recommended for production of grain-finished beef of an acceptable quality level. In addition, the target endpoint for harvest (11-mm external fat thickness over the longissimus at the 12th rib) resulted in production of mostly Select and low Choice beef carcasses; 92% of the resulting carcasses qualified for these two grade levels. Application of the prototype quality system reduced the expected rate of nonconformance to desired tenderness specifications from about one in four loin steaks (23% for top sirloins and 26% for strip loins) to approximately one in eight loin steaks (13% for top sirloins and 12% for strip loins). Tenderness comparisons among sires suggested that the rate of nonconformance for strip loin steaks might be reduced even further by control of genetic inputs into the system. Use of process control in a quality management system was demonstrated to be an effective approach for assurance of beef tenderness.

Animal Feed↗
PubMed2005

Practical management of chemotherapy-induced nausea and vomiting.

Approximately 70% to 80% of all patients who receive chemotherapy experience nausea and vomiting, which can disrupt their lives in numerous ways. Chemotherapy-induced nausea and vomiting (CINV) has traditionally been classified according to three patterns: acute, delayed, and anticipatory. Additional classifications include refractory and breakthrough nausea and vomiting. The mechanisms by which chemotherapy causes nausea and vomiting are complex, but the most common is thought to be activation of the chemoreceptor trigger zone. An appreciation of the risk factors for developing CINV is important when matching antiemetic treatment to risk. The emetogenicity of the chemotherapy regimen--generally categorized as high, moderate, low, or minimal--greatly affects a patient's risk for developing CINV In addition to established and emerging pharmacologic approaches to managing CINV, many complementary and integrated modalities may be options. Progress in CINV management must include a better understanding of its etiology and a focus on prevention. This review will consider the etiology, assessment, and treatment of patients with CINV.

Antiemetics↗
PubMedDate not supplied

Use of evidence-based practice management guidelines in trauma care.

A PMG is a tool developed by a consensus process, with the input of all trauma care practitioners who are involved in the care of a patient with a specific clinical issue. The group that develops the PMG uses current, evidence-based data, carefully introduces and monitors the PMG in the clinical setting, and evaluates the success of the PMG in accomplishing the goals identified at the beginning of the process. The ultimate goal of a PMG is to eliminate unnecessary practice variations, with the end point of achieving quality care. Participating in the development of a guideline with a review of the literature serves as an excellent educational process for all practitioners.

Critical Pathways↗
PubMedDate not supplied

Associations between farmers' personal characteristics, management practices and farm performance.

A survey was carried out in a random sample of 123 dairy farms from the east of Ireland. The monthly mean production per cow was 315 l of milk and 11.5 kg of fat. The mean log herd somatic cell count was 5.45 (arithmetic mean = 372,573 cells/ml), with almost 50% of the monthly counts over 300,000 cells/ml in a 12-month period. Bivariate and multivariate analysis was performed to assess the relative impact of the personal characteristics of the farmer and the management policies he applied on the amount and quality of the milk produced. In five out of six models the group of variables related to farmers' attitudes, values, and sociodemographic profile explained a similar or greater amount (between 14.44 and 34.35%) of the variation of farm performance than the group of management variables (between 14.33 and 25.99%) as measured by the R2. These results stress the importance of the human factors in explaining variation in farm performance.

Analysis of Variance↗
PubMed1997

[General practice management and therapy of terminally ill patients--a longitudinal study].

Since most persons in Germany die outside a hospital, the aim of the study was to quantify GP and nursing services for persons in the ten weeks prior to death. GPs were asked to document patients they considered to be terminal, using a set of different documentation sheets: 1. age, sex, living situation, and diagnoses, 2. time, place, duration, services, and nursing intensity for every contact and 3. circumstances of death. GPs were told to expect three-month periods to be documented. Twenty-six practices participated, documenting 47 patients and 582 contacts. Mean age of the deceased was 76 years (31 to 98); 21 were male and 26 female. Patients were classified as "terminal" on average 70 days prior to death (median 50 days). Average number of doctor-patient contacts increased from 0.7/week to 1.6 in the third and second last week and 2.4 in the final week. Average number of hospital days were around 1.1/week for the whole period. Nursing hours by relatives increased to over 13 h/day in the final week. Professional home nursing services were available for 80% in the final week, but only for 3 h/day. Thirty-two patients (68%) died at home, 7 (15%) in a nursing home and 8 (17%) in hospital (after a mean of 6 days as in-patients). The results document the large amount of time needed by physicians, relatives and nurses in the last weeks of life for persons who die at home.

Adult↗