Time management networking session.
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Maximization of the nurse administrator's managerial time is the focus of this article. Activities inventory, goal setting, assessing peak and low times, scheduling activities, using transition times, streamlining paperwork, using the telephone, office visits, and meetings are discussed. The author addresses planning, organizing, staffing, directing, and controlling at the organizational level as ways to maximize organizational time.
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UNLABELLED: Successful outcome following cardiac arrest have been reported in the range of 13-59%. It is well established that the time from the onset of a ventricular arrhythmia to successful defibrillation predicts outcome. Recent out of hospital arrest protocols minimizing time to defibrillation have reported significant improvement in outcomes. The Bethesda conference and American Heart Association (AHA) both set standards for defibrillation time for in hospital codes but do not set standards for other interventions. In February 2000, the Brooke Army Medical Center (BAMC) cardiopulmonary resuscitation committee published time guidelines for the initiation of CPR, emergency team arrival, first defibrillation and first medication. We sought to evaluate resuscitation outcomes before and after this intervention. METHODS: Data on each response time was prospectively collected as was etiology for the event, emergency location, patient age, gender, and emergency outcome for the 7 months prior to the guideline introduction and 15 months afterwards. RESULTS: The mean response times (in minutes) for initiation of CPR (1.3 vs. 0.4), emergency team arrival (1.6 vs. 1.2), first defibrillation (7.8 vs. 6.6) and first medication (4.1 vs. 3.8) demonstrated trends toward improvement. Compliance with the time standards also increased (67-91, 85-95, 67-71 and 93-86%, respectively). Emergency survival trended toward improvement (47 vs. 57%) while discharge survival significantly increased from 3 to 24% (P=0.017). CONCLUSIONS: Setting time guidelines for Advanced Cardiac Life Support (ACLS) improved initiation of CPR, emergency team arrival, first defibrillation, and first medication administration. These time reductions were accompanied by improved event survival and a statistically improved survival to discharge.
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BACKGROUND: Medical microbiology practice encompasses a diverse range of activities. Consultant medical microbiologists (CMMs) attribute widely differing priorities to, and spend differing proportions of time on various components of the job. AIM: To obtain a professional consensus on what are high-priority and low-priority activities, and to identify the time spent on low-priority activities. METHOD: National survey. RESULTS: Many respondents felt that time spent on report authorisation and telephoning of results was excessive, whereas time spent on ward-based work was inadequate. Timesaving could also be achieved through better prioritisation of infection-control activities. CONCLUSION: CMMs should apportion their time at work focusing on high-priority activities identified through professional consensus.
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The expansion of publicly funded home care services and case management (CM) programs has fueled concerns about containing the costs of these programs. For CM practice, the issue is one of tailoring CM to those who really need it and are most likely to benefit from it. This concern calls for a better understanding of factors that increase the need for CM resources, defined as the use of CM time. This study of 242 clients in a Medicaid-waiver-funded home care program found clients' problem behaviors, higher functional ability, informal support problems, and problems with service provider agencies to be predictive of greater use of CM time. These findings suggest the need to develop appropriate assessment of problem areas, implement effective protocols to manage specific problems, and address such issues as appropriate levels of staffing and provider accountability.