urban hospitals

..In our hospital an important problem was failure to call the medical emergency team or cardiac arrest team when, before in-hospital cardiac arrest, patients had fulfilled the criteria for calling the team...

..To examine the relationship between hospital and emergency department (ED) occupancy, as indicators of hospital overcrowding, and mortality after emergency admission...

..CONCLUSION: Improvement in management techniques might unravel the mysteries of death of unknown origin. Management of medical emergencies should be emphasized in the training of accident and emergency workers...

..6% v 4.1%; chi2 = 1.82; P = 0.18). CONCLUSIONS: Antibiotic therapy for CAP prescribed in Australian EDs varied. Concordance with national CAP guidelines was generally low. Targeted interventions are required to improve concordance...

..The objectives were to: examine the extent of adherence to various protocols in relation to medication activities and determine how the ward environment impacts on graduate nurses' use of protocols to manage patients' medications...

..pneumoniae...

..A significant portion of patients already known to be colonized or infected with Methicillin-Resistant Staphylococcus aureus (MRSA) may not be identified at admission by neighboring hospitals...

This article describes the development of an evidence-based practice and research collaborative among urban hospitals. The collaborative began as a mechanism to support the incorporation of evidence-based practice and research in the ..

..CONCLUSION: A case study linked to an evaluation using 'accountability for reasonableness' can serve to improve priority-setting in the context of hospital strategic planning...

To examine the seroprevalence of undiagnosed HIV and variation by season among patients admitted to the general internal medicine (GIM) and trauma services of two urban hospitals.

..It also has 4 central hospitals, each with one or more surgeons. Most district hospitals are manned by a single doctor and two or more paramedical clinical officers...

..In this paper we describe this period of turbulent change that has left most of the city's safety-net and small community hospitals near bankruptcy...

..decline during 1991-94? (3) Did self-pay/charity patients' propensity to use safety-net hospitals increase during 1991-94? (4) Did the change in Medicaid patients' use of safety-net hospitals differ for low- and high-risk patients?..

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..The odds ratio for contracting a SARS-CoV infection among persons with either a homozygous or a heterozygous Cw*0801 genotype was 4.4 (95% confidence interval, 1.5 to 12.9; P = 0.007)...

..In this work we present the design, methodology of the study and various baseline characteristics of people with ACS...

..To test the hypothesis that frequent attenders to the ED are suitable for diversion to general practice...

..The main objective of this study is to apply autoregressive integrated moving average (ARIMA) models to make real-time predictions on the number of beds occupied in Tan Tock Seng Hospital, during the recent SARS outbreak...

..We also make recommendations for other institutions to prepare for future outbreaks, regardless of their origin...

..These efforts produced increased accessibility of hospital emergency departments and greater efficiency of acute and long-term care...

..We determined the feasibility of using an interactive laptop program with adolescent emergency department (ED) patients to prevent alcohol use and misuse...

..To explore the association between daily patient numbers, sociodemographic, clinical and system characteristics and walkout rates of patients from New South Wales (NSW) public hospital ED (without seeing a medical officer)...

..A competency framework for Chinese registered nurses was formed. This paper describes the development and testing of the Competency Inventory for Registered Nurses (CIRN)...

..Limited availability of on-call specialists is thought to contribute to ED overcrowding...

..3% deaths were in the age group of 0-28 days. Sepsis was the most common diagnosis in patients who died. This information may help in planning and development of a Pediatric Emergency unit and prioritizing residents, training...

..Although airway management by emergency physicians has become standard for general emergency department (ED) patients, many believe that anesthesiologists should manage the airways of trauma victims...

..Safety belt use among potentially at-risk groups in Boston is unknown. We sought to assess the prevalence and correlates of belt non-use among emergency department (ED) patients in Boston...

..The role of the Nurse Practitioner (NP) was introduced to the Emergency Department (ED) at a metropolitan hospital in Melbourne, Australia in July 2004...

..The ability of case management interventions to reduce the volume of visits and associated impact on reducing Emergency Department overcrowding was not proven...

..To examine the causes of death in each category...

..In our opinion, successfully planning emergency patients requires that the ED has full control over the referral process, and that scheduled patients are treated in a separate, undisturbed care process...

..The findings point to possible explanations regarding problems in pain assessment, and provide insights into our understanding of nursing practice especially in relation to pain assessment...

..We studied the ability of patients to recognize the severity of asthma, implement SC therapy, and seek timely help from a health-care provider (HCP)...

..This study was undertaken to identify the frequency of items containing pharmaceutical advertising in clinical emergency departments (EDs)...

..The study identified how nurses' prioritization of work demands created barriers in conducting timely and comprehensive pain assessment decisions...

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..Surprisingly, the strength of the HCP referral did not influence the decision to attend CR as strongly when compared to the HCP's ability to facilitate enrollment in a CR program...

..More aggressive traffic policing of the village roads should be done by the relevant authorities...

..Further testing will be required to verify the efficacy of the test in populations with a higher prevalence of phencyclidine and amphetamine abuse...

..2%) compared with transfer to level II trauma centers. CONCLUSIONS: Patients with severe head injuries transferred from rural trauma centers to level I centers are likely to have improved survival relative to transfer to level II centers...

..7% of these patients had severe sepsis. The emergency physician must have a high index of suspicion for infections when evaluating organ transplant recipients...

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..It is argued that identification of differences of perception is an essential part of the risk management process. Illustrations are given of ways in which these differences can undermine the effectiveness of a risk management strategy...

..Although pain scores did not improve, there were improvements made with respect to patient assessment, patient satisfaction, and nursing knowledge...

..Interestingly, a remuneration problem exists in a market different from what one would expect. In this study, a sample from a suburban hospital, rather than an inner-city university hospital, is the greater problem...

..Data will be collected through a variety of sources...

..Assessment of emergency department (ED) patient complexity using the number of procedures, investigations or consultations (PICsum)...

..It reduces the number of patients leaving prior to being seen by a doctor and it provides one way of getting around access block and a physically small department...

..Evaluation of compliance with advice and appropriateness of emergency presentation following contact with a telephone triage service (HealthDirect)...

..While the LOS targets were not met, decreasing the LOS to the achieved levels resulted in the highest levels of patient satisfaction ever achieved and sustained in the ED...

..To assess nurse overtime in acute care general hospitals and the factors that influence overtime among various hospitals and in the same hospitals from year to year...

..To identify the prevalence of drug misuse (illicit, over-the-counter and prescribed) by patients at Bristol Royal Infirmary, an inner-city teaching hospital, and the problems encountered by ward staff in the management of these patients...

..To determine the timeliness of the care provided to patients with type-B pelvic ring injuries at the emergency service...

..Factors affecting recovery from injury are investigated comparing male emergency department patients involved in work-related and non-work-related accidents...

..To measure communication loads on clinical staff in an acute clinical setting, and to describe the pattern of informal and formal communication events, Australia...

..Communication principles and strategies are presented to nurse leaders for use in fostering a stronger organizational affiliation among staff nurses while maintaining a strong identification with the nursing profession...

..The study was designed to evaluate the accuracy of urinary indices as diagnostic tests to identify acute dehydration...

..20 and r = -0.17, respectively). CONCLUSIONS: Efforts to improve ED patient satisfaction should focus on improving patients' perceptions that wait intervals are appropriate rather than simply shortening wait intervals per se...

..Although successful treatment of eating disorders on medical units has occurred for at least thirty years, some insurance companies refuse payment for such care...

..We prospectively evaluated the prevalence of cocaine use in emergency department patients with elevated diastolic blood pressure greater than 120 mm Hg...

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..Outpatient PIM use in older ED patients is highly prevalent. Further education is needed regarding prescribing practices in this population group...

..ED attendance data have important implications for funders and providers of ED services and a national dataset should be established...

..CONCLUSIONS: Episodic, but frequent, overcrowding is a significant problem in academic, county, and private hospital EDs in urban and rural settings. Its causes are complex and multifactorial...

..As managed care grows, the determination of ED appropriateness may depend on open discussions between physician groups, as well as on access to timely care in office settings...

..Emergency department computerized triage logs might be useful for automated ED surveillance and potentially for early identification of bioterrorism events. We describe a Web-based surveillance program and its feasibility for surveillance...

..The rate of admission and length of stay for children who were evaluated in the ED were also examined...

..We assess the effect of sequential modifications in laboratory processing, including pneumatic tube transport and fully computerized order management, on laboratory turnaround time in the emergency department (ED)...

..These findings may be the result of the differences in status/authority, responsibilities, gender, training, and nursing and physician cultures...

..We hypothesized, however, that in the context of a cranial CT scan that did not demonstrate a shunt malfunction, obtaining the shunt series would not prove to be clinically useful...

..We found that male patients were most often restrained for violent and disruptive behavior. Most commonly, two restraints were used in combination with chemical restraints for a duration of almost 5 h...

..Trauma victims spent the shortest mean time in accident and emergency before death, the longest staying were the victims of medical diseases...

..Guidelines for venous thromboembolism prophylaxis exist, yet prophylaxis is underutilized and inadequately studied in the context of emergency department admissions...

..Previous investigations demonstrate that nursing case management in the acute care setting improves patient outcomes. However, these findings provide limited information specific to trauma patients...

..Conclusion: Examiner characteristics do not influence either the pain or the embarrassment associated with IPE in the ED...

..This study was a prospective validation of the Ottawa Ankle Rules (OAR) in Australia following appropriate education in the use of the rules...

..Decisions on early feeding are often guided by grandmothers and influenced by beliefs that infants need complementary food to counteract signals of hunger, reduce crying, and sleep through the night...

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..To empirically test a clinical prediction rule for evaluating HIV-infected patients complaining of headache and to identify those at low risk for intracranial mass lesion who do not need immediate computed tomography of the head...

..Rates of rapid second births among low-income black adolescent mothers range from 20% to 50%. Most efforts to prevent rapid second births have been unsuccessful...

..This report describes findings in study participants at the age of 4 years...

..Other design characteristics of the materials including organization, writing style, appearance, and appeal also were assessed...

..aided by the Indian Space Research Organization) permits transmission of ECGs from rural points to central urban hospitals for physician interpretation...

..6%). Access to formal ethics support services was associated with work in urban hospitals. Informal ethics resources were more evenly distributed...

..The infrastructure and organization of AMI care in rural and urban Kansas hospitals was examined...

To empirically estimate the effects that managed care has had on physician and clinical integration in urban hospitals.

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..Poorly executed transfers of older patients from hospitals to long-term care facilities carry the risk of fragmentation of care, poor clinical outcomes, inappropriate use of emergency department services, and hospital readmission...

..professionals, and medical equipment, and patients are increasingly referred by clinical protocols to larger urban hospitals. On the other hand, many rural communities value highly their local rural hospital, and advocate the ..

..This study examines differences between urban and rural hospitals...

..library and training in its use would support medical decision making in rural southern Indiana and achieve the same level of impact seen by targeted information services provided by health sciences librarians in urban hospitals.

..of Cameroon, examined whether there were significant differences in job satisfaction between nurses in urban hospitals and rural community health settings in the six major components of the job: work, pay, promotions, ..

..To examine the use of pro re nata (PRN) (as needed) medication in hospitalized patients with psychotic disorders...

..Little is known about the effects of WIC on infant growth, health, and food security...

..These standards are based on research conducted largely in urban hospitals, and it may not be possible to generalize them to rural hospitals.

..Results showed that ownership and hospital size were significantly associated with hospital closure. Urban hospitals were less likely to close than rural hospitals...

..There may be differences in the length of stay (LOS) between children hospitalized in rural versus urban hospitals. This study compared the differences in LOS, conditional LOS (CLOS), odds of prolonged stay, and 21-day ..

Patients with acute myocardial infarction have higher mortality rates in rural hospitals than in urban hospitals, suggesting substandard quality of care in the rural setting...

..The use of steady state as the endpoint for performance of indirect calorimetry (IC) is controversial. We designed this prospective study to evaluate the necessity and significance of achieving steady state...

..Over a 4 1/2-year period we enrolled a diverse sample of 6350 normal infants by age 2 mo at 2 urban hospitals and 6 private pediatric practices, and we intensively monitored their middle-ear status prospectively...

..BMI) and postpartum depression (PPD) in a sample of women delivering on the obstetric services of two large urban hospitals in Salt Lake City, Utah and 2...

..The NETT SEC brings together an extensive array of high volume urban and sub-urban hospitals with a well established tract record of expertise and experience in conducting ground breaking research in ..

..evaluation and the overall clinical outcome in black and white patients with ESLD who were treated at three urban hospitals in Boston between 1994 and 1998, and 2) To determine if there are racial differences in knowledge and ..

..OB/GYN or advanced practice nurse providers, (N=10-12) from prenatal care clinics at two tertiary care, urban hospitals in Southeastern Michigan...

..OB/GYN or advanced practice nurse providers, (N=10-12) from prenatal care clinics at two tertiary care, urban hospitals in Southeastern Michigan...

..of support for caregivers of persons with stroke during the first year after rehabilitation treatment at two urban hospitals. The primary aim of the study is to examine if the Caring web can: 1) improve the caregiver's well being, e.g...

..This project will investigate whether rural/community hospitals and academic/urban hospitals can adopt a long-term simulation strategy, what obstacles must be overcome to achieve adoption, how ..

..Such an approach should provide an early detection assay for asymptomatic women. ..

..If the tailored intervention is effective. it could be an inexpensive way for other urban hospitals across the nation to improve compliance with cervical cancer screening for African American patients...

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..The impact of this set of tools will be substantial as groups such as the NSQIP, SCIP, National Quality Forum, and Leapfrog Group continue to endorse PBB as a key strategy to reduce surgical morbidity and mortality. ..

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..S., as well as policy efforts ultimately aimed at improving the health of people with HIV. ..

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..In summary, this clinical trial will assess the efficacy and safety of inhaled nitric oxide for amelioration of a major disease of premature infants. ..

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..Validated measures of risk will be used in combination with women's own perceptions of need. ..