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At least 19 recordsLinked to original sources
PubMedDate not supplied

[Nursing Intervention Classification (N.I.C.) and Nursing Outcome Classification (N.O.C,) of Iowa University: a description of methods, tools and contents].

This article is meant to introduce NIC and NOC classification by briefly describing the methodological pathway that was used to realize the two classifications and the underpinning philosophy that has enforced its implementation. The taxonomic structures of both classifications will be described too and the involvements on its use in the clinical field.

Education, Nursing↗
PubMed1988

Organization and operation of the hospital-infection-control program of the University of Iowa Hospitals and Clinics.

The University of Iowa Hospitals and Clinics is located in the center of the United States in Eastern Iowa, has 1,000 hospital beds, and is the largest university owned teaching hospital in the country. Over 35,000 patients are admitted each year. The infection control efforts began in 1969 and were broadened in 1976 with the establishment and implementation of the Program of Epidemiology directed by W.J. Hierholzer, Jr., M.D., hospital epidemiologist. Hospital-wide surveillance is routinely performed by three and a half full-time equivalent LPN practitioners who assess problems and evaluate data essential to realistic identification of nosocomial infection rates, implementation of controls and evaluation of control measures. Nosocomial infection surveillance, utilizing modified CDC criteria, has been performed since July 1976. Ward rounds are made by staff, utilizing nursing care and medication Kardex's, microbiology, hematology and X-ray reports. Importantly, the surveillance system is being validated by concurrent prospective surveys to determine the sensitivity and specificity of reporting data. Outbreaks/epidemics of infections, such as Legionella pneumonia, diarrhea of unknown species, and wounds, as well as burns from manufactured changes in cautery grounds, have been identified and controlled before they have become major epidemics. Surveillance has identified one epidemic per 10,000 patients admitted.(ABSTRACT TRUNCATED AT 250 WORDS)

Cross Infection↗
PubMed2005

Intensity-modulated radiation treatment for head-and-neck squamous cell carcinoma--the University of Iowa experience.

PURPOSE: To review the University of Iowa experience with intensity-modulated radiotherapy (IMRT) in the treatment of head-and-neck squamous cell carcinoma. METHODS AND MATERIALS: From October 1999 to April 2004, 151 patients with head-and-neck squamous cell carcinoma were treated with IMRT for curative intent. One patient was lost to follow-up 2 months after treatment and therefore excluded from analysis. Of the remaining 150 patients, 99 were treated with definitive IMRT, and 51 received postoperative IMRT. Sites included were nasopharynx, 5; oropharynx, 56; larynx, 33; oral cavity, 29; hypopharynx, 8; nasal cavity/paranasal sinus, 8; and unknown primary, 11. None of the patients treated with postoperative IMRT received chemotherapy. Of 99 patients who had definitive IMRT, 68 patients received concurrent cisplatin-based chemotherapy. One patient received induction cisplatin-based chemotherapy, but no concurrent chemotherapy was given. Three clinical target volumes (CTV1, CTV2, and CTV3) were defined. The prescribed doses to CTV1, CTV2, and CTV3 in the definitive cohort were 70-74 Gy, 60 Gy, and 54 Gy, respectively. For high-risk postoperative IMRT, the prescribed doses to CTV1, CTV2, and CTV3 were 64-66 Gy, 60 Gy, and 54 Gy, respectively. For intermediate-risk postoperative IMRT, the prescribed doses to CTV1, CTV2, and CTV3 were 60 Gy, 60 Gy, and 54 Gy. RESULTS: The median follow-up was 18 months (range, 2-60 months). All living patients were followed for at least 6 months. There were 11 local-regional failures: 7 local failures, 3 regional failures, and 1 failure both in the primary tumor and regional lymph node. There were 16 patients who failed distantly, either with distant metastasis or new lung primaries. The 2-year overall survival, local progression-free survival, locoregional progression-free survival, and distant disease-free survival rates were 85%, 94%, 92%, and 87%, respectively. The median time from treatment completion to local-regional recurrence was 4.7 months (range, 1.8 to 15.6 months). Only one marginal failure was noted in a patient who had extensive tonsil cancer with tumor extension into the orbit and cavernous sinus. Patients with oropharyngeal cancer did significantly better than patients with oral cavity and laryngeal cancer, with a 2-year local-regional control rate of 98%, compared with 78% for oral cavity cancer and 85% for laryngeal cancer (p = 0.005). There was no significant difference in local-regional control for patients who received postoperative radiation or definitive radiation (p = 0.339) and for patients who had chemotherapy or not (p = 0.402). Neither T stage nor N stage had a significant effect on local-regional control (p = 0.722 and 0.712, respectively). CONCLUSIONS: Our results have confirmed the effectiveness of IMRT in head-and-neck cancer. It offers excellent outcomes in local-regional control and overall survival. More studies are necessary to further improve the outcomes of laryngeal cancer as well as oral cavity cancer.

Adult↗
PubMed2002

An innovative model of health care delivery: the care management program of the University of Iowa.

The Indigent Patient Care Program (legislatively enacted in 1915) provides comprehensive health care to indigent Iowans without health insurance. The University of Iowa Hospitals and Clinics, a leading academic medical center, was designated as the health care provider for these medically and socially complex patients. The Care Management Program of the University of Iowa (CMPUI) is an innovative care delivery model responsible for total health management of patients enrolled in the indigent program. The CMPUI is a solution to preserve the tripartite missions of an academic medical center while ensuring the preservation of the historic Indigent Patient Care Program in Iowa.

Academic Medical Centers↗
PubMed1995

DSM-IV field trial: testing a new proposal for somatization disorder.

OBJECTIVE: The purpose of this study was to evaluate for APA a proposed strategy to diagnose somatization disorder for possible inclusion in DSM-IV. METHOD: Five sites--Washington University, University of Kansas, University of Iowa, University of Arkansas, and Mount Sinai Medical Center in New York--participated in a collaborative field trial. Female subjects (N = 353) were recruited from several different services (psychiatry, internal medicine, and family practice) and were evaluated for the presence or absence of the disorder. This assessment was performed with a new instrument constructed by combining all the criteria for somatization disorder from the proposed criteria for DSM-IV, DSM-III, DSM-III-R, Perley-Guze, and proposed criteria for ICD-10. RESULTS: A high level of concordance was found between the proposed diagnostic strategy for DSM-IV and the current criteria (DSM-III-R), as well as the earlier criteria (Perley-Guze and DSM-III). The ICD-10 criteria agreed poorly with all other criteria sets. The level of experience of the rater (expert versus novice) with the earlier (Perley-Guze, DSM-III) and current (DSM-III-R) criteria did not influence the identification of cases by use of DSM-IV criteria. No racial effect was introduced by any of the criteria sets. CONCLUSIONS: The strategy for DSM-IV is an accurate and simpler method of diagnosing somatization disorder that does not require special expertise for proper use.

Adult↗
PubMed1995

Cost-effective health information systems: user-driven internal development at the University of Iowa.

GOALS: The Information Network For Online Retrieval & Medical Management (INFORMM), health information system (HIS) for the University of Iowa Hospitals and Clinics (UIHC), was analyzed with regard to development of a Computer-Based Patient Record (CBPR) in a cost-effective manner. The analysis: i) profiles INFORMM system functionality; ii) displays INFORMM use and satisfaction among physicians, nurses, and other hospital employees; iii) characterizes dynamics affecting INFORMM growth; and iv) evaluates the cost of a system of internal-development of software. DATA SOURCES: INFORMM utilization for 1989, 1994, and 1995; service requests from users for the years 1985, 1990, and 1994; 1994 MECON-PEERx data; gap analysis user survey conducted by an independent consulting firm. MAIN RESULTS: 1) Physician use has been dominated by a single function: retrieval of laboratory results. 2) Nurse use of the system was more diverse. A recent surge of nurse and physician use resulted from the introduction of online documentation of nursing care. 3) Overall use has been predominantly by non-clinician users, no one function dominating their pattern of use. 4) User service requests were predominantly from the non-clinician group of users. Requests from non-physician groups have been coordinated by a limited number of representatives of those groups, unlike requests from physicians. 5) The UIHC HIS ranked high in user satisfaction. 6) The overall cost of the UIHC HIS system is relatively low as a percentage of the gross operating budget or as a ratio to the volume of patient activities in this medical center. CONCLUSIONS: Internal development of INFORMM has been a cost-effective solution to the information demands of nursing staff and other users. INFORMM system composition reflects the quantity and organization of user requests. Satisfying the needs of physicians requires a change in the manner in which physician needs are assessed.

Attitude to Computers↗
PubMedDate not supplied

Prevalence of Toxoplasma gondii antibodies among veterinary college staff and students, Iowa State University.

Serum samples obtained from two groups within the College of Veterinary Medicine, Iowa State University, were examined for Toxoplasma gondii antibodies. Serum samples from 65 (26.0%) of the 250 persons examined yielded a titer of 1:16 or greater by the indirect fluorescent antibody test. A prevalence of 33.3% was obtained for 108 Veterinary Medical Research Institute (VMRI) personnel. Fof 142 veterinary students, the reactive rate was 20.4%. There was a marked difference of results within the student group--the reactive rate of 31.0% of 58 members of the class of 1975 was significantly higher (p less than 0.05) than the 13.1% for 84 members of the class of 1976. Studies on multiple serum samples were carried out on 55 VMRI personnel; 17 showed a change in serologic reactivity but only 5 had titers of 1:64 or greater. No definitive relationships could be determined between the epidemiologic characteristics examined and the presence of T. gondii antibodies. Characteristics examined included age, sex, primary residency, food habits (eating of rare beef and smoked pork products), and extent of animal contact.

Adolescent↗
PubMed1981

Survival of cutaneous malignant melanoma patients at University of Iowa Hospitals: 1950--1974.

Survival of 387 patients treated for cutaneous malignant melanoma at University of Iowa Hospitals during the period 1950--1974 was analyzed. For the entire period, the observed five-year survivals were 57% for women and 33% for men; the corresponding ten-year survivals were 43 and 23%. For both men and women, there was an impressive improvement in outcome between the earliest and the latest periods, so that for 1970--1974, the five-year observed survival was 68% for women and 49% for men. Data are presented on mean age at diagnosis, distribution by stage, site, and sex, and survival by site and sex. The question is raised whether the biologic nature of malignant melanoma is variable, so that increased incidence is associated with better prognosis.

Adolescent↗
PubMed1981

Experience with germ cell tumors of testicle at University of Iowa.

Between 1964 and 1979, 219 patients with germ cell testicular tumors were treated at the University of Iowa. In 79 nonseminomatous germ cell tumors various chemotherapeutic regimens were used. The response, salvage, and survival rates are compared. There is a definite trend toward better response rates and survival using the combination cisplatinum, vinblastine (Velban), and bleomycin. With this combination, 75 per cent of Stage II and III patients survived two years. The over-all response rate was 85 per cent, and 87 per cent of those with a complete response survived two years. Eighty per cent of deaths occurred within two years and 90 per cent within three years.

Antineoplastic Agents↗
PubMed1991

Late-onset congenital syphilis. A retrospective look at University of Iowa Hospital admissions.

A retrospective review of 766,742 hospital admissions was performed between 1966 and 1986 at the University of Iowa Hospital for the diagnosis of congenital syphilis. Although 88 individuals were identified with this diagnosis, adequate treatment was documented in only 33 (38%). Thirty-nine of the 88 individuals identified were initially seen for visual complaints by the ophthalmology department. We recommend that all physicians increase their index of suspicion for this disease, and institute appropriate therapy and follow-up if late congenital syphilis is diagnosed.

Adolescent↗
PubMed2005

A future model of musculoskeletal rehabilitation at the University of Iowa Hospitals and Clinics: spanning the continuum of care.

Models of rehabilitation care vary widely within academic medical centers, with most housing their own inpatient rehabilitation units. The University of Iowa Hospitals and Clinics focuses both on acute hospital inpatient and outpatient rehabilitation care instead of leaving rehabilitation to local community-based hospitals. This article discusses a method to provide adult inpatient rehabilitation care, and simultaneously provide specialized rehabilitation teams capable of spanning the entire continuum of rehabilitative care from admission at a Level I Trauma Center to the conclusion of successful outpatient rehabilitation needs. The costs of implementation of this plan can be justified by avoiding increased expenses already being incurred in addition to successful capture of outpatient rehabilitation revenues.

Continuity of Patient Care↗
PubMed1997

C.S. O'Brien: founder of the Department of Ophthalmology, the University of Iowa.

Cecil Starling O'Brien, M.D. (1889-1977), was the founder (1927) of the Department of Ophthalmology at the University of Iowa, and he is credited with the establishment of a strong department that has made many important contributions to ophthalmology. The surviving O'Brien residents were interviewed on videotape, and this article is a composite of their memories together with a brief biographical sketch of Dr. O'Brien.

Academic Medical Centers↗