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PubMed1993

Methicillin-resistant Staphylococcus aureus. Past, present, and future.

The MRSA control program at UCDMC is one of many approaches used in hospitals today. With this less restrictive program, we have been able to maintain control of MRSA for approximately 5 years. By establishing a threshold for investigation at four new nosocomial cases per month, the ICD has been able to maintain a manageable endemic level of MRSA. Figure 2 shows the downward trend of new cases of MRSA per fiscal year. During 1991, however, we experienced clustering of cases in two areas of the hospital along with a major outbreak in our burn unit. This is reflected in the significant rise in the number of new cases for that year. Even with these outbreaks, however, we have been able to re-establish control. Figure 3 represents the number of new MRSA cases per month during fiscal year 1991. After the peak in April, we have again seen a downward trend, with an average of four new cases per month during the first quarter of fiscal year 1992. The success of this program is attributed to the cooperation and excellent communication among the hospital departments who are active participants in this control program. It is also owing to the establishment of a very active antibiotic control program that discourages inappropriate use of antimicrobial agents. This team effort is critical to the success of any infection control program. Infection control protocols are constantly changing, even if they are directed toward the same pathogen. Hospital epidemiology provides us with a very systematic approach to controlling the spread of disease. During the process, however, we are constantly collecting new information about the pathogen, allowing us to re-evaluate and, we hope, improve our approach to control. This is one reason for the numerous approaches to control found in the vast array of MRSA literature. MRSA continues to be a challenge of the 1990s. It appears to be an increasing problem in US hospitals, regardless of hospital size. Although its elusive behavior evades the most comprehensive and carefully planned control programs of even the most skilled hospital epidemiologists, hospitals continue to struggle for control of this organism. The alternative to control is probable resistance to vancomycin, which would have devastating public health consequences, particularly as alternative antibiotic therapy is not yet available.

Cross Infection↗
PubMedDate not supplied

Cardiac rehabilitation with nurse care management and telephonic interactions at a community hospital: program evaluation of participation and lipid outcomes.

Cardiac rehabilitation (CR) can help patients with heart disease control some risk factors, limit new coronary artery lesions, and decrease death rates. However, participation rates in CR are low. Using a descriptive design, we evaluated a modified CR program in which nurse care managers used telephonic communication with patients in their homes by comparing it to a traditional CR program in a hospital setting. Using multivariate analysis we compared the patient cohorts eligible for each of the programs, and program participants to the nonparticipants for each program. Compared to traditional CR, the modified CR program with nurse care management was associated with significantly improved participation rates (11% vs. 22%) and the apparent overcoming of several well-described barriers to CR participation (distance from the hospital and domestic isolation). Risk factor management, including testing of serum lipids and achieving goals for lipid reduction, for participants in both CR programs was superior to risk factor management for nonparticipants.

Aged↗
PubMed2004

An application of multidisciplinary education to a campus-community partnership to reduce motor vehicle accidents.

OBJECTIVE: A collaborative campus-community partnership program provided the framework for an intervention to reduce motor vehicle accident fatalities along a rural Appalachian highway. Students from public health, nursing and medicine worked with community members to identify the problem and plan the strategy to address it. METHODS: An inquiry-based learning model proved to be an appropriate approach to engage student teams with community leaders in identifying and resolving health needs. Inquiry-based strategies place students in guided learning situations where their investigations lead to working solutions. The inquiry-based model matched the curricular objectives of the Community Partnership Program (CPP) more closely than the classroom oriented problem-based learning approach. IMPLEMENTATION: In the spring of 1994, students, along with citizens and officials of a rural Appalachian county, initiated a community-based prevention project focused on reducing deaths from motor vehicle accidents employing the principles of an inquiry-based learning model. DISCUSSION: This project effectively demonstrates the role that students can play in mobilizing diverse elements of the community to address identified health and safety concerns. It provides an illustration that a longitudinal, community-based, service-learning approach to health professions education is beneficial to both student learners and communities. CONCLUSIONS: Through the use of inquiry-based learning methods, students gained real life experience in applied principles of health statistics, epidemiology, community organization, health risk communication, health education planning and program implementation. Outcomes of the project included a measurable reduction in automobile-related fatalities and the initiation by the state department of transportation of a series of investigations expected to pave the way for physical improvements to the roadway.

Accidents, Traffic↗
PubMed1985

Increasing team skills: an evaluation of program effectiveness.

The need for health professionals with caring values and good communication skills is well established. To develop these skills requires building self-esteem, as is supported by the work of Carl Rogers, Maslow, and Jourard, and the development of communication skills, as is supported by Carkhuff. A six-hour developmental program was evaluated using alternate forms of the highly validated Personal Skills Map. The differences in participants' scores showed increases in self-esteem, comfort, and management skills (p less than .00), while aggression (p = .05) and deference (p less than .00) decreased. A longitudinal follow-up of participants showed that 65% continued to use the assessment tool six months to one year later. The program appears to be well suited for service settings, continuing education, and academic settings, and meets the need of a high tech, high touch era of change.

Allied Health Personnel↗
PubMed1980

Assessment of family planning service delivery in Egypt.

The Arab Republic of Egypt has used family planning service delivery as the main vehicle for implementing its national family planning policy since 1965. This paper reports results of a study undertaken during 1975-77 using a systematic sample of 100 health units offering family planning services in two governorates of Egypt. The findings suggest that there is considerable potential for improving the service delivery system through better management. Broadening the choice of technology offered, increasing the quantity and quality of outreach and communication activities for new and continuing contraceptors, and improving staff availability could lead to improvements in national program participation and continuation.

Contraceptive Agents↗
PubMed1991

Dual purpose computer aided program for cardiac catheterization laboratory data management.

This communication describes the design criteria used in the early systems analysis activity of the cardiac laboratory. This analysis activity required an understanding of the cardiology laboratory environment, the establishment of needs to be answered by the program, and the goals of the entire system. The rationale for inclusion of various cardiologic, demographic, quality assurance, and personnel safety parameters is discussed. The input forms used, the database structure created, and the information provided by an applications system are described. Since the system is built around a general-purpose computer (the IBM PC or compatible) and widely available powerful general purpose software, the entire system may be used for many other cardiology laboratory data management tasks.

Cardiac Catheterization↗
PubMed2001

Customizing for clients: developing a library liaison program from need to plan.

Building on the experiences of librarian representatives to curriculum committees in the colleges of dentistry, medicine, and nursing, the Health Science Center Libraries (HSCL) Strategic Plan recommended the formation of a Library Liaison Work Group to create a formal Library Liaison Program to serve the six Health Science Center (HSC) colleges and several affiliated centers and institutes. The work group's charge was to define the purpose and scope of the program, identify models of best practice, and recommend activities for liaisons. The work group gathered background information, performed an environmental scan, and developed a philosophy statement, a program of liaison activities focusing on seven primary areas, and a forum for liaison communication. Hallmarks of the plan included intensive subject specialization (beyond collection development), extensive communication with users, and personal information services. Specialization was expected to promote competence, communication, confidence, comfort, and customization. Development of the program required close coordination with other strategic plan implementation teams, including teams for collection development, education, and marketing. This paper discusses the HSCL's planning process and the resulting Library Liaison Program. Although focusing on an academic health center, the planning process and liaison model may be applied to any library serving diverse, subject-specific user populations.

Academic Medical Centers↗
PubMed2004

Health care delivery in the Texas prison system: the role of academic medicine.

Faced with explosive growth in its prison population and a legal mandate to improve medical care for incarcerated offenders, the state of Texas implemented a novel correctional managed health care program in 1994. The organizational structure of the program is based on a series of contractual relationships between the state prison system, 2 of the state's academic medical centers, and a separate governing body composed of 9 appointed members, which include 5 physicians. All medical, dental, and psychiatric care for more than 145,000 offenders, incarcerated under the jurisdiction of the Texas Department of Criminal Justice, is provided by the University of Texas Medical Branch and Texas Tech University Health Sciences Center. The health delivery system is composed of several levels of care, including primary ambulatory care clinics in each prison unit, 16 infirmaries at strategic locations throughout the state, several regional medical facilities, and a dedicated prison hospital with a full range of services. Specialized treatment programs have been established at various units for patients with chronic conditions, such as hypertension, diabetes mellitus, major psychiatric disorders, hepatitis, and human immunodeficiency virus infection. Significant improvements in health outcomes have occurred since the managed care program was established.

Academic Medical Centers↗