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At least 1,207 records · Page 67Linked to original sources
PubMed1981

Training and evaluation of respiratory therapists in emergency intubation.

Endotracheal intubation in emergency situations is a recognized function of respiratory therapists, as defined by the American Association for Respiratory Therapy in 1973. A training program based in the operating room, using one-on-one instruction, was the basis for a training program designed to meet JCAH standards for endotracheal intubation. To evaluate the success of our training and our system for attempting intubations, we recorded the results of 50 consecutive intubation attempts by our therapists. All 50 patients were eventually intubated, with 35 patients intubated on the first attempt. The average number of attempts per patient was 1.48. While 39 patients were intubated within one minute, 11 required more than one minute. In five patients, physicians had attempted intubation prior to a therapist's arrival; those intubations took eleven times longer than those that were attempted by therapists only. The average time for intubations attempted solely by therapists was 54 seconds.

Clinical Competence↗
PubMed1999

Health care managers' and administrators' roles, functions, and responsibilities.

Health care managers and administrators are increasingly assuming leadership and management responsibilities for multiple units and departments. To determine key roles, functions, and responsibilities of nursing and other health care managers and administrators, a survey was conducted to identify the perceived importance and amount of time these individuals devote to selected activities. Although the amount of time and perceived importance of selected activities varied with each environmental context, some key roles, functions, and responsibilities across practice disciplines did emerge. Regardless of the environmental context, administrators and managers at all levels in health care organizations spend significant amounts of time and place high value on communication, problem solving and decision making, collaboration with other disciplines, people development, and cost containment.

Administrative Personnel↗
PubMedDate not supplied

Risk factors associated with early respiratory disease complex in broiler chickens.

Early respiratory disease complex (ERDC) is a term coined to describe an acute disease characterized by depression, respiratory distress, and increased mortality in 2-to-3-wk-old broiler chickens. Postmortem lesions include airsacculitis, fibrinous pericarditis, and perihepatitis. Colisepticemia is the primary cause of death. In order to investigate the association between ERDC and farm management factors, a retrospective case-control study was conducted by collecting data covering a 6-mo period (January-June 1997) from four broiler integrators on the Delmarva peninsula. Univariate and multivariate statistical analyses revealed that flock size was positively associated (P = 0.02) and layout time was negatively associated (P = 0.05) with ERDC.

Acute Disease↗
PubMed1999

Patient product availability through the use of systems thinking: developing coherent relationships.

The traditional techniques of quality improvement, such as just-in-time delivery, can only go so far in dealing with materiel management issues. A further step is necessary: the implementation of systems thinking. This type of thinking focuses on the interconnectedness of all the members that exist throughout the system. This article explains the nature of systems thinking and how it can be used in materiels management to describe and improve the availability of materiels needed.

Contract Services↗
PubMed2000

Consumer-driven cholecystectomy: myth or reality?

OBJECTIVE: To discover if a consumer-driven process is fueling the high rate of cholecystectomies in the laparoscopic era. DESIGN: A 12-question survey. SETTING: A 1000-bed, university-affiliated hospital. PATIENTS: Patients admitted for elective cholecystectomies. MAIN OUTCOME MEASURES: Survey responses suggesting positive perceptions about laparoscopic cholecystectomy persuade patients to undergo gallbladder surgery. RESULTS: Patients' symptoms persisted for a mean of 20.7 months, range zero to 204. Mean time between diagnosis and surgery was ten months, range 0.1-312. Ninety-five and three-tenths percent knew their gallbladder would be removed; 1.7 percent thought it would be opened to extract stones. Ninety-one and four-tenths percent correctly identified the procedure as "laparoscopic cholecystectomy." Fifty and four-tenths percent believed they would fully recover within a week, 24.1 percent within two weeks, and 14.7 percent within two days. Eighty-three and two-tenths percent knew laparoscopic cholecystectomy required less cutting; 33.6 percent thought a laser was used. Forty-four and eight-tenths percent assumed laparoscopy was the safer method. Sixty-two and one-tenth percent were referred for surgery by family physicians; Seven percent approached surgeons themselves. When asked who first suggested the laparoscopic procedure, 43.1 percent indicated family doctor, 41.4 percent, surgeon, and three percent requested laparoscopy themselves. Twenty-four and one-tenth percent who delayed surgery despite more than 12 months of symptoms indicated escalating pain as their reason for seeking surgery now; 0.9 percent cited the newer procedure. CONCLUSIONS: We found no clear evidence that consumer awareness of laparoscopy has encouraged more cholecystectomies. Misconceptions exist about the procedure's execution and safety. Education about risks, especially bile duct injury, is needed. More frequent referral by family doctors probably plays a role in the higher incidence of cholecystectomies.

Cholecystectomy, Laparoscopic↗