Дисертації з теми "Inpatient hospital care"
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Omérov, Majda. "Violence in psychiatric inpatient care /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-850-5/.
Повний текст джерелаDrager, Katrina A. "Inpatient psychiatric length of stay and readmission rates." Menomonie, WI : University of Wisconsin--Stout, 2007. http://www.uwstout.edu/lib/thesis/2007/2007dragerk.pdf.
Повний текст джерелаBechel, Diane Lynn. "The effect of patient-centered care on hospital inpatient cost and quality outcomes the experience in southeast Michigan." Ann Arbor, Mich. : University of Michigan, 1998. http://books.google.com/books?id=bhUvAAAAMAAJ.
Повний текст джерелаWong, Oi-ling Irene. "Medical ecology of inpatient service utilization in Hong Kong a population survey /." Click to view the E-thesis via HKUTO, 2003. http://sunzi.lib.hku.hk/hkuto/record/B31971337.
Повний текст джерелаElo, Jyrki A. I. "The impact of surgical day care on hospital inpatient utilization in a paediatric population." Thesis, University of British Columbia, 1987. http://hdl.handle.net/2429/27876.
Повний текст джерелаMedicine, Faculty of
Population and Public Health (SPPH), School of
Graduate
Holibaugh, Adam Russell. "Reducing inpatient hospital acquired pneumonia (HAP) using a structured oral care program." Thesis, Boston University, 2013. https://hdl.handle.net/2144/21176.
Повний текст джерелаHospital acquired pneumonia (HAP) causes significant mortality and morbidity and is now no longer reimbursed by Centers for Medicare and Medicaid (CMS). For all of these reasons, hospitals want to minimize their HAP rates. Aggressive oral care (tooth brushing 3 times a day) has been shown to reduce the incidence of HAP in the intensive care unit setting, but this has not been tested in the acute care setting, in which patients are more stable, less sick, and more ambulatory. In an attempt to address HAP rates in acute care settings, this clinical trial entailed providing all patients in four wards with a 3 times per day tooth-brushing oral care protocol, which was implemented or supervised by the nurses on each ward. Six matched wards on a separate campus that received normal standard of care served as controls. The goal of this clinical trial was to cut the pneumonia rate in half, from 2% to 1%. This clinical trial was conducted to determine whether an oral care regimen would reduce the incidence of aspiration pneumonia over the three months of intervention in the experimental group (HAC) versus the control group (ENC) from Nov 5, 2012 to Feb 15, 2013.
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Haile, Brian. "The costs of adult inpatient care for HIV disease at GF Jooste Hospital." Master's thesis, University of Cape Town, 2000. http://hdl.handle.net/11427/9434.
Повний текст джерелаThe lack of patient care and utilisation data impairs the ability of hospital and clinic administrators to make informed, data-driven policy choices. This concern is particularly acute with HIV/AIDS, given both the striking growth in the local epidemic over the last two years and the high level of HIV-related health expenditures shouldered by the provincial medical system in the Western Cape province of South Africa. A retrospective chart review was conducted to capture clinical and utilisation data of from a sample of 59 inpatients, who were admitted to a township secondary hospital near Cape Town, South Africa during 1997. Three years of data were abstracted and analysed.
George, Allison M., and Erin N. Baguley. "Clinical and Economic Characteristics of Inpatient Esophageal Cancer Mortality in the United States." The University of Arizona, 2010. http://hdl.handle.net/10150/623745.
Повний текст джерелаOBJECTIVES: To assess disease-related and resource consumption characteristics of esophageal cancer mortality within hospital inpatient settings in the United States from 2002 to 2006. METHODS: This retrospective investigation of adults aged 18 years or older with diagnoses of malignant neoplasms of the esophagus (ICD-9: 150.x) utilized nationally-representative hospital discharge records from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample. Cases resulting in inpatient death were analyzed with respect to patient demographics, payer, hospital characteristics, number of procedures and diagnoses, Deyo-Charlson disease-based case-mix risk adjustor, and predominant comorbidities. RESULTS: Overall, 168,450 inpatient admissions for esophageal cancer were observed between 2002 and 2006, averaging 66.3 + or - 11.9 years, length of stay of 10.3 + or - 15.2 days, and charge of $51,600 + or _ 92,377. Predominant comorbidities within these persons included: secondary malignant neoplasms; disorders of fluid, electrolyte, and acid-base balance; pneumonia; respiratory failure/collapse or insufficiency; sepsis; anemia; hypertension; cardiac arrhythmias; obstructive pulmonary disease; acute or chronic renal disease; and heart failure. Significant predictors of increased charges included longer lengths of stay, higher numbers of diagnoses and procedures, median annual family income over $45k, urban hospital location, and presence of heart failure, chronic pulmonary disease, fluid and electrolyte disorders, or metastatic cancers (P< or = 0.05). Longer lengths of stay were associated with higher total charges, female sex, larger number of diagnoses and procedures, Medicaid, black race, increased case-mix severities, and fluid and electolyte disorders (P< or = 0.05). CONCLUSIONS: Patient mortality occurs in over one-tenth of esophageal cancer hospital admission cases. Further research is warranted to understand the impact of various comorbidities or treatment approaches and to assess potential disparities in lengths of stay.
Abrahamsen, Grøndahl Vigdis. "Patients’ perceptions of actual care conditions and patient satisfaction with care quality in hospital." Doctoral thesis, Karlstads universitet, Avdelningen för omvårdnad, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-9023.
Повний текст джерелаOgbuji, Victoria Ngozi. "Improving Spiritual Care in Preoperative Nursing." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7246.
Повний текст джерелаWood, III John. "The Influence of Emergency Department Wait Times on Inpatient Satisfaction." Thesis, University of North Texas, 2019. https://digital.library.unt.edu/ark:/67531/metadc1609108/.
Повний текст джерелаQuosdorf, Ashley. "Connecting with Adolescent Mothers: Perspectives of Hospital-Based Perinatal Nurses." Thesis, Université d'Ottawa / University of Ottawa, 2019. http://hdl.handle.net/10393/38838.
Повний текст джерелаWong, Oi-ling Irene, and 黃愛玲. "Medical ecology of inpatient service utilization in Hong Kong: a population survey." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B31971337.
Повний текст джерелаLovell, Mariann Engelhard. "Factors associated with inpatient tertiary hospital utilization and home care referral in patients diagnosed with Cancer /." The Ohio State University, 1999. http://rave.ohiolink.edu/etdc/view?acc_num=osu1488191667181637.
Повний текст джерелаPerera, K. Prasadini N. "Impact of Post-Discharge Care Setting Following Inpatient Hospitalization on Hospital Revisits in a Medicare Population." Diss., The University of Arizona, 2013. http://hdl.handle.net/10150/301686.
Повний текст джерелаIlkhani, Mahnaz. "The inpatient hospital care delivery to disabled children and young people and those with complex health needs." Thesis, University of Southampton, 2013. https://eprints.soton.ac.uk/362860/.
Повний текст джерелаFadayevatan, Reza. "Inpatient hospital care for older people : relationship between comprehensive geriatric assessment (CGA), frailty and outcomes in eldery hospitalized patients." Thesis, University of Sheffield, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.443880.
Повний текст джерелаWright, Michael Christopher. "Spiritual health care : an enquiry into the spiritual care of patients with cancer within the acute hospital and the specialist inpatient palliative care unit in England and Wales." Thesis, University of Sheffield, 2001. http://etheses.whiterose.ac.uk/3041/.
Повний текст джерелаBrody, Abraham Aizer. "The effects of an inpatient palliative care team on mortality, utilization, and cost in a large non-profit teaching hospital." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3324586.
Повний текст джерелаViljoen, Charle André. "Audit of the quality and cost of acute inpatient stroke care in the general medical wards at Groote Schuur Hospital." Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/21377.
Повний текст джерелаJackson, Phillip E. "Analysis of Naval Hospital Long Beach efforts to recoup subsistence cost from referral of active duty members to civilian and VA hospitals for inpatient care." Thesis, Monterey, California. Naval Postgraduate School, 1992. http://hdl.handle.net/10945/23534.
Повний текст джерелаThis thesis analyzes the efforts of Naval Hospital, Long Beach to recoup subsistence cost from the referral of active duty members to civilian and Veterans Administration hospitals for inpatient care. The analysis encompasses Fiscal Years 1990, 1991 and 1992 and begins by providing an overview of the Navy Medical Department. Additionally, pertinent background information directly related to the area of research is elaborated on to facilitate understanding. Particular attention is devoted to the Collection Agent, Admissions Office and Command Referral Clerk operations and interactions. Pay Adjustment Authorization procedures are reviewed along with a glance at AQCESS MSA to ascertain whether the current version of software provides the existing capability to account for occupied bed days outside the hospital. A questionnaire is employed to gather the data necessary to evaluate the processes used at the hospital and estimate the amounts available for recoupment. Comparisons of the estimated amounts are contrasted against funding authority and reimbursables. The analysis concludes with a cost and benefit analysis, a brief observation of three other medical treatment facilities, and recommendations..
Enarson, Penelope Marjorie. "Improving the quality of care for inpatient management of childhood pneumonia at the first level referral hospital : a country wide programme." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/96840.
Повний текст джерелаENGLISH ABSTRACT: Pneumonia is the greatest single cause of mortality in children less than five years of age throughout the world causing more deaths than those due to AIDS, malaria and tuberculosis combined. Approximately 50% of all childhood pneumonia deaths occur in sub-Saharan Africa. Children in developing countries being treated for pneumonia frequently have one or more comorbid conditions which increases their risk of dying. The proper management of the child with severe or very severe pneumonia is essential to reduce case fatality. Standard case management (SCM) of pneumonia, has been shown to be an effective intervention to reduce deaths from pneumonia, but what is lacking is a means of delivering it in low-resource/high burden countries. A major barrier to wide application of this intervention in low-income countries is weak health-care systems with insufficient human and financial resources for implementing SCM to a sufficient number of children at a level of quality and coverage that would result in a significant impact. The objective of this dissertation is to address this issue by investigating ways of improving delivery of standard case management of pneumonia in district hospitals throughout Malawi, a high HIV-prevalent country which would result in a decrease in the in-hospital case fatality rates (CFR) from pneumonia in children less than five years of age. We reviewed the evidence base for SCM. Then we evaluated the development and implementation of a national Child Lung Health Programme (CLHP) to deliver SCM of severe and very severe pneumonia and a programme to provide uninterrupted oxygen supply in all paediatric wards at District Hospitals throughout Malawi. We demonstrated that it was feasible to implement and maintain both programmes country-wide. Thirdly we evaluated the trend in case fatality rates in infants and young children (0 to 59 months of age) hospitalized and treated for severe and very severe pneumonia over the course of the implementation of the CLHP. The findings from this study showed that in the majority (64%) of cases, who were aged 2-59 months with severe pneumonia there was a significant effect of the intervention that was sustained over time whereas in the same age group children treated for very severe pneumonia there was no interventional benefit. No benefit was observed for neonates. Fourthly we investigated factors associated with poor outcome reported in the previous study, in a subset of this cohort to determine the individual factors including demographics of the study population, recognised co-morbidities and clinical management that were associated with inpatient death. This study identified a number of factors associated with poor pneumonia-related outcomes in young infants and children with very severe pneumonia. They included co-morbidities of malaria, malnutrition, severe anaemia and HIV infection. The study found that the majority of reported comorbid conditions were based on clinical signs alone indicating a need for more accurate diagnosis and improved management of these comorbidities that may lead to improved outcomes. Other identified factors included a number of potentially modifiable aspects of care where adjustments to the implementation of SCM are indicated. These included enhancing correct classification of the severity of the disease, the use of correct antibiotics according to standard case management, more extensive availability and use of oxygen together with oximetry to guide its use,. Finally recommendations were made to address the identified reasons for poor outcomes and suggested future research.
AFRIKAANSE OPSOMMING: Pneumonie is die grootste enkele oorsaak van sterftes by kinders jonger as 5 jaar in die wêreld en veroorsaak meer kindersterftes as die menslike immuungebrekvirus (MIV), malaria en tuberkulose saam. Ongeveer 50% van kindersteftes van pneumonie kom in sub-Sahara-Afrika voor. Kinders in ontwikkilende lande, wie vir pneumonie behandel word, het dikwels een of meer bydraende toestande wat die doodsrisiko verhoog. Kinders wie ernstige of baie ernstige pneumonie onderlede het moet korrek behandel word om sterfte te voorkom. Die standaard protokolle om kinderpneumonie korrek te behandel het getoon om effektief te wees om die sterftesyfers te verlaag. In lae inkomste lande bestaan die strategieë nie om die protokolle aan te wend nie. ‘n Groot struikelblok in die aanwending van die pneumonie behandelingsprotokolle in lae-inkomste lande is die swak gesondheidsorgsisteme met onvoldoende menslike en finansiële hulpbronne. Die tekorte gee aanleiding tot die beperkte implementering van pneumonie protokolle wat die omvang en kwaliteit van die pneumonie protokolle beperk en daarom impakteer die protokolle nie op die kindersterftesyfer nie. Die doel van die verhandeling is om hierdie probleem aan te spreek deur navorsing hoe om die pneumonie protokolle landwyd in alle distrikhospitale in Malawi, ‘n land met ‘n hoë MIV prevalensie, aan te wend om sodoende die kindersterftesyfer (kinders jonger as 5 jaar) as gevolg van pneumonie te verlaag. Ons het die getuienis van die pneumonie protokolle ondersoek. Hierna is ‘n nasionale Kinderlong Gesondheidsprogram ontwikkel en landwyd geïmplementeer. Volgens die program is kinders met ernstige en baie ernstige pneumonie volgens Wêreldgesondheidsorganisasie (WGO) protokolle behandel. Ononderbroke suurstoftoevoer in alle pediatriesesale in distrikshospitale in Malawi veskaf. Die navorsing het getoon dat die implementering en instandhouding van pneumonie behandelingsprotokolle is landwyd moontlik. Verder het ons die tendens ondersoek of die kindersterftesyfer in babas en jong kinders (0 tot 59 maande) wat in die hospital opgeneem en behandel is vir ernstige en baie ernstige pneumonie tydens die implementering van pneumonie protokolle verminder het. Die bevindinge van hierdie verhandeling wys dat in die meerderheid (64%) van die kinders tussen 2 en 59 maande met ernstige pneumonie, en met die toepassing van die pneumonie protokolle, statistiesbetekenvol die sterfte syfer verlaag het. Die protokolle vir die behandeling van baie erstige pneumonie het nie dieselfde wenslike effek gehad nie. In neonate (jonger as 2 maande) was daar ook geen verlaging in die sterftesyfer nie. Laastens het ons die redes vir die swak uitkomste ondersoek in ‘n substudie en veral klem gelê op bydraende siektes en kliniesesorg tekorte geassosieer met pneumonie sterftes. Die studie het ‘n aantal faktore geïdentifiseer wat bygedra het tot die sterftesyfer in kinders met baie ernstige pneumonie en in neonate. Die geïdentifiseerde bydraende faktore het malaria, wanvoeding, erge anemie en MIV-infeksie ingesluit. Voorkomende maatreëls moet vir die geïdentifiseerde faktore ingestel word. Aanpassings in die pneumonie protokolle is voorgestel. Ten slotte word aanbevelings gemaak om die geïdentifiseerde redes vir swak uitkomste aan te spreek en verdere navorsingidees word aanbeveel.
Quirk, Alan. "Obstacles to shared decision-making in psychiatric practice : findings from three observational studies." Thesis, Brunel University, 2007. http://bura.brunel.ac.uk/handle/2438/5464.
Повний текст джерелаGipson, Linda Stephens. "The Impact of Managed Care on the Utilization and Distribution of Inpatient Surgical Procedures with Demonstrated Volume and Outcome Endogeneity." Scholar Commons, 2011. http://scholarcommons.usf.edu/etd/3118.
Повний текст джерелаShafi, Mohammed. "Relationship between Patient of Safety Culture and Hand Hygiene among inpatient nurses: a retrospective study from a tertiary care hospital in the Middle East." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1571298284402806.
Повний текст джерелаPeers, Gordon H. "Home visiting: The effect of a hospital based nurse home visiting programme on the rehabilitation of children following their discharge from a child psychiatry inpatient unit." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1997. https://ro.ecu.edu.au/theses/898.
Повний текст джерелаHolmgren, Emma, and Hedvig Tell. "Patienters upplevelse av att vårdas på flerbäddssal." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-352333.
Повний текст джерелаBackground: As medical care looks today it is common for patients to be treated in a multi-bed room, which can be experienced differently by patients. There may be situations where it is difficult to preserve the patient's integrity and autonomy when being treated in a multi-bed room. Purpose: The purpose of this study was to study the patient's experience of being treated in a multi-bed room. Method: A literature study with qualitative articles from the databases Pubmed and Cinahl. Results: A compilation of twelve articles was made. Four different categories emerged; sleep, privacy, fellowship and well-being. These categories describe the patient's experience of care in a multi-bedroom. Some patients experienced that they could be disturbed by their roommates. However, some patients were anxious about interfering with their roommates themselves, which affected the patient's sleep quality. The curtains between the beds in the multi-bed room were sometimes not sufficiently shielded which lead to the roommates easily overheard private conversations. The patients appreciated when the nurses attempted to maintain patient integrity, for example by adding an extra blanket to reduce bodily exposure. Patients could feel a fellowship with each other in the multi-bed rooms, thus finding comfort and security in each other. Conclusion: The feeling of having a private space and the possibility of privacy was very important when getting care in a multi-bedroom. However, other patients felt that the multi-bedroom was homelike because they enjoyed the social interaction. Therefore, it was often positive to have a roommate. The patients felt a fellowship and thus found comfort and security with each other. Because everyone is unique, they experience situations differently and the nurse cannot assume that everyone wants to be cared for in the same way. A nurse should take care of each patient in an individualized manner where the nurse is responsible for the patient's integrity.
Miller, Lakisha Chitique. "Medical Resident Turnover and Its Association with Inpatient Mortality in Patient Discharges with a Primary Diagnosis in the Heart Disease, Cancer, or Stroke Diagnostic Groups at U.S. Teaching Hospitals, 2002." Case Western Reserve University School of Graduate Studies / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=case1239044238.
Повний текст джерелаGong, Zhiping. "Developing casemix classification for acute hospital inpatients in Chengdu, China /." Access full text, 2004. http://www.lib.latrobe.edu.au/thesis/public/adt-LTU20050314.195349/index.html.
Повний текст джерелаIncludes bibliographical references (leaves 320-329). Also available via the World Wide Web.
Lucas, D. Pulane. "Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital." VCU Scholars Compass, 2013. http://scholarscompass.vcu.edu/etd/2996.
Повний текст джерелаMolina, Karine Lorenzen. "A satisfação dos usuários segundo a forma de internação em hospital universitário." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2015. http://hdl.handle.net/10183/128955.
Повний текст джерелаA satisfaction survey is an important indicator of quality. The entrance door is seen as a “thermometer” of the quality of care provided by the health system. Overcrowded emergency rooms and long waiting time for elective hospitalizations are a reality in many hospitals. This study analyzed users’ satisfaction according to the type of inpatient stay – emergency or admission – in a university hospital; described their demographic profile, compared the satisfaction of users; presented aspects of care about praises, criticisms and suggestions; and investigated the influence of the length of stay in the satisfaction of users. Belonging to a longitudinal study this research was of a survey type, carried out in a public university hospital in southern Brazil. The sample consisted of users over 18 years old, hospitalized for at least 48 hours in clinical and surgical units. The research instrument consisted of sociodemographic, stay-in and satisfaction variables, and two open questions. The collection of data was carried out by phone in a period of 15 to 30 days after hospital discharge. The analysis of the study was of a descriptive and analytical type. Three hundred and sixty-seven users were eligible, 174 were hospitalized by emergency and 192 by admission, 52% were female, 50.9% adults and young adults, 51% live with a partner, 47.7% have more than 8 years of study, 77.7% were admitted by the Unified Health System (SUS), and the average of hospitalization were 13.6 days. For the emergency group, 51.7% were elderly people, 51.5% of users reported praise and the length of hospitalization had correlation with the dimensions of admission (rS =.236), with the team of nutrition (rS =.203), and discharge (rS =.218). For the group that entered by admission, 57.1% highlighted criticism and the length of hospitalization had correlation with the admission (rS=.185). Considering the outcome “users’ satisfaction”, 33.3% replied to be satisfied and 66.1% very satisfied with the service received. The only dimension of satisfaction that did not show any statistical difference between the two groups was the nursing team. This study pointed to the fragility of the health system in relation to the care of the elderly and bed management processes, but demonstrated a high level of user’s satisfaction regarding the assistance provided in the referred university hospital.
La pesquisa de satisfacción es un importante indicador de calidad. La puerta de entrada es mirada como un “indicador” de la calidad del atendimento ofertada por el sistema de salud. Emergencias superlotadas y largos períodos de espera para ingresos efectivos son una de las realidades en los hospitales. Esto estudio analisó la satisfacción de los usuários según la forma de ingreso-emergência y admisión- en hospital universitário, describió el perfil sociodemográfico, comparó la satisfacción de usuários, levantó aspectos del atendimiento cuanto a elogios, crítica y sugerencias e investigó la influencia del tiempo de ingreso en la satisfacción de los usuários. Integrante de un estúdio longitudinal, esta pesquisa fué del tipo survey, realizada en un hospital público, universitario y general en el Sur del Brasil. La amuestra se constituyó de usuários mayores de 18 años ingresados en el mínimo 48 horas en unidades clínicas y cirúrgicas. El instrumento de pesquisa constó con variables sociodemográficas, de ingreso, de satisfacción y dos preguntas abiertas . La coleta fué realizada por teléfono en el período de 15 a 30 días apos el alta del hospital. La análisis del estúdio fué del tipo descriptiva y analítica, fueron escogidos 367 usuarios, 174 ingresaron por la emergência y 192 por la admisión, 52 del sexo femenino, 50,9% adultos y adultos jóvenes, 51% viven con compañero, 47,7% tienen más de 8 años de estudio, 77,7% ingresaron por el Sistema Único de Salud y la media de ingreso fué de 13,6 días. Para el grupo de emergencia 51,7% fueron ancianos, 51,5% de usuários destacaron elogios y el período de ingresso tuvo correlación con las dimensiones de admisión (rS=.236), con el equipo de nutrición (rS=.203) y con el alta (rS=.218). Para el grupo que ingresó por la admisión 57,1% destacaron críticas y el período de ingresso tuvo correlación con la admisión (rS=.185). Llevando en cuenta el desfecho satisfación de los usuários 33,3% respondieron estar satisfechos y 66,1%muy satisfechos con la atención recebida. La única dimensión de satisfacción que no tuvo diferencia estatística entre los dos grupos fué a de el equipo de enfermeira. Este estúdio demonstró la fragilidade del sistema de salud frente a los cuidados con los ancianos y cuanto a los procesos de gestión de lechos, pero demonstró un elevado nível de satisfacción de los usuários con la asistencia prestada en hospital universitário.
Silva, Magda Aparecida dos Santos. "Efetividade de duas modalidades de equipe de cuidado no controle de sintomas em pacientes com câncer avançado." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-17042015-130238/.
Повний текст джерелаIntroduction. Although there are many different strategies for provision of palliative care to patients with cancer, little is known about the effectiveness of these modalities. Objective.To compare the effects of a palliative care team integrated with traditional care to traditional care alone on symptom control in inpatients with advanced cancer. Method. Longitudinal study composed of two non-randomized groups. Seventy-three patients were admitted to the palliative care team integrated to traditional care (PCT Group) and compared to 75 patients treated in the traditional care model (TC Group). Symptoms were assessed by the Edmonton Symptom Assessment Scale (ESAS), satisfaction with treatment by the verbal numeric scale (0-10), performance status by the Karnofsky Performance Status Scale (KPS) and analgesic adequacy by the Pain Management Index (PMI). Patients were assessed upon admission, and after 24 and 48 hours. The primary outcomes were significant clinical improvements of 2 points in pain intensity and nausea in 48 hours, compared to admission. The demographic data, symptoms, and reduction in symptoms were compared between the groups by using Fisher\'s or Mann Whitneys Exact Tests. The Wilcoxon test examined the intragroup alteration of symptoms. The Poisson multiple regression controlled for confounding factors of improvement in symptoms. A p-value of 0.05 indicated statistical significance for all analyses. Results. The prevalence of symptoms at admission was high in both groups. In the PCT Group, it ranged from 43.8% (depression) to 87.7% (loss of well-being) and, in the TC Group, it ranged from 24% (dyspnoea) to 85.5% (pain). The magnitude of median score of symptoms was substantial in both groups: at admission for the PCT group, it ranged from 5.5 (sense of well-being) to 8.0 (anxiety, appetite, constipation, sadness), while for the TC Group, it ranged from 6.0 (sense of well-being and dyspnoea) to 9.0 (loss of appetite). The median score of the symptom burden assessed by ESAS was 50.0 in both groups. In 24 hours (intragroup), the PCT Group had significant reductions in intensity of five symptoms (pain, nausea, loss of appetite, dyspnoea, and sleep disturbance) and symptom burden, while the TC Group had significant reductions in intensity of three symptoms (pain, nausea, and sleep disturbance). In 48 hours (intragroup), the PCT Group had significant reductions in intensity of ten symptoms and symptom burden and while the TC Group had significant improve in intensity of four symptoms. Multiple regression analysis showed that pain (RR = 2.2 [95% CI 1.27-3.81]) and loss of well-being (RR = 4.6 [95% CI 1.34-15.88]) were reduced by two points and it was significantly more favourable only in the PCT Group. The PMI revealed better adequacy of analgesia in the PCT Group. Satisfaction was high and similar in both groups. Conclusion. Patients with advanced cancer in both groups showed a pronounced burden of symptoms and only pain was properly controlled in the PCT Group. The results indicate that factors that can improve treatment strategy should be implemented to improve the effectiveness of clinical assistance. Examples of factors that can improve treatment are frequent and systematic assessment of symptoms in short periods, and strategies that allow for timely adjustment of therapy when necessary.
Morreale, Mark J. "Evaluation of a care map for community-acquired pneumonia hospital inpatients." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq22365.pdf.
Повний текст джерелаPham, Le Hung Sirikul Isaranurug. "Oral health care performance for inpatients among nurses at Hanoi City Hospitals, Vietnam /." Abstract, 2008. http://mulinet3.li.mahidol.ac.th/thesis/2551/cd414/5038006.pdf.
Повний текст джерелаOliver, David. "The development and evaluation of strategies to predict and prevent falls in elderly hospital inpatients." Thesis, King's College London (University of London), 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.271463.
Повний текст джерелаHelmicki, Soni. "Evolution and Devolution of Inpatient Psychiatric Services: From Asylums to Marketing Madness and Their Impact on Adults and Older Adults with Severe Mental Illness." Thesis, University of North Texas, 2017. https://digital.library.unt.edu/ark:/67531/metadc984274/.
Повний текст джерелаAsplund, Sandra, and Annina Riskula. "Hur patienter i livets slutskede upplever omvårdnaden på sjukhus : en litteraturöversikt." Thesis, Sophiahemmet Högskola, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-3757.
Повний текст джерелаBackground: When it has been established that life-prolonging treatment is no longer meaningful, care goes to the latter phase, the final stage of life. The final stage of life means that death is inevitable in the near future and the goal of treatment is to alleviate the suffering. Good palliative care is based on the four cornerstones of symptom relief, multi-professional collaboration, relationship and communication, and support for close relatives. Together with a person-centered approach, the four cornerstones can be applied by all health care professionals with the aim of providing patients with improved well-being and improved quality of life at the final stage. Aim: The purpose of this literature review was to describe how patients who are at the final stage of life experience nursing care in hospitals. Method: The chosen design for the essay was a literature review and 15 scientific articles which form the basis for the result. In the article search, the databases Public Medline [PubMed] and the Cumulative Index to Nursing and Allied Health Literature [CINAHL Complete] were used. The result was compiled by an integrated analysis. Results: The results were divided into main categories that described the patients' experience of the hospital environment, the meeting with the nurse, symptom relief, and existential needs. Together with the subcategories, the results show that the patients who were in the final stages of life were generally satisfied, although deficiencies could be identified. The shortcomings that could be pointed out were about how the patients experienced the hospital environment where, for example, multi-bed rooms negatively affected their quality of life. The patients also described how they experienced the hospital staff being stressed and disengaged, which contributed to the patient feeling like a burden. Conclusions: Knowledge about palliative care in hospitals for patients at the final stage of life is, based on the results of this paper, an important topic to elucidate. With an increased life expectancy as well as new research and technology for life-sustaining measures, the need for palliative care will be increasingly demanded. Lack of knowledge to convey good care to people at the final stage of life results in impaired well-being and reduced quality of life for patients who are in the late palliative stage.
Figueredo, Delcina Jesus. "Autocuidado em idosos internados numa enfermaria geriátrica de um hospital-escola: comparação das avaliações subjetivas e objetiva." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5169/tde-20092016-160109/.
Повний текст джерелаProspective, longitudinal quantitative study in elderly people and their proxies, of both genders, admitted at a geriatric ward of a school hospital, whose data collection was August 2013 to March 2014. Objective: to evaluate subjective and objective functional condition of elderly people admitted at a geriatric ward; among the reports of self care performance and their needs for help. Method: subjective and objective evaluations using the instrument Performance test of Activities of Daily Living (PADL), with 16 tasks associated to 3 items of Instrumental Activities of Daily Living (IADL). Results: Female gender was predominant among the elderly (32 - 58.2%) and the proxies (46 - 83.6%); clients´ age varied between 64 and 99 (x=80) years old and their proxies between 37 and 84 years old (x=58.7y); basic education was more frequent among the elderly (36 - 65.4%) and higher (18 - 32.7%) for their proxies. Regarding the family connection of proxies, 30 (54.4%) were daughters and 12 (21.5%) wives. In order to compare the subjective and objective functionalities to perform self care, it was calculated the Concordance Index (CI), which varied from 62 to 93%, whose Kappa was between 0.20 and 0.59. Both elderly people and their proxies referred performing tasks with or without help. However, on the objective evaluation it was detected greater need for help or incapability to perform a task. It must be highlighted that elderly people evaluated themselves a little better than their proxies. Discussion: elderly subjective and proxy subjective evaluations in comparison to objective ones, elderly responses for self care were confirmed in objective evaluation and the reports provided subjectively by their proxies. It was verified that the functionality level of elderly people in majority was level 3 (do it without help) for PADL daily life activities and IADL instrumental activities. Elderly subjective reports in comparison to objective evaluation, it can be seen that some elderly people perform their activities without help, others with help and the ones who don´t perform tasks by themselves required some kind of help. Subjective information reported by proxies was discordant in comparison to objective evaluation in some items of the instruments. Elderly people are more prone to evaluate themselves better than their proxies. Proxies reported that elderly people can perform their tasks, but in the objective evaluation it was not observed. Conclusions: there are important differences between the functional capacities reported by elderly themselves and their proxies when compared to the direct observation of these tasks by the nurse, which points to the need of actions and care more focused on the direct evaluation rather than reports by clients and their proxies
Rydningen, Lene Christin. "Medicine Management and Administration : How might we improve patient safety through medicine management and administration in inpatient care units in somatic hospitals in Sweden and Norway?" Thesis, Umeå universitet, Designhögskolan vid Umeå universitet, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-152356.
Повний текст джерелаIntroduction
This thesis explores how we can increase patient safety through medicine management and administration in inpatient care units in somatic hospitals in Sweden and Norway by combining tools and systems which allows nurses to work safely, precicely, and efficiently whenever they are managing or administering medication to patients.
Background
Nurses have the formal, academic, and moral responsibility in medicine management and administration in hospitals (1). The nurse must ensure that the medication is given to the correct patient, that it is the correct kind of medication, correct form, correct strength, correct dose, correct administration method, and that it is given at the correct time (1). Regardless of these 7 points of control, adverse drug events still happen.
Methodology
Through a human centered design approach this thesis explores design challenges and opportunities to how we can improve the medicine managment and administration process within somatic hospitals in Sweden and Norway.
Result
The final design proposal, Memo, suggests an ecosystem which make all medication traceable by incorporating a closed loop medicine management approach, making information accessible and consistent across digital and physical platforms, and having a precise, accessible, and informative electronic medicine list. Memo eliminates risks of medicine errors by designing barriers within the system which make it harder for the nurse to make an error. The aim is to increase patient safety.
Memo is developed together with nurses and pharmacists from 3 different hospitals in Sweden and Norway.
Gingi, Pelisa. "Factors associated with the psychological response of nurses’ victims of inpatients violence in a psychiatric facility for adults with intellectual disability in cape town." Thesis, University of the Western Cape, 2012. http://hdl.handle.net/11394/4024.
Повний текст джерелаMagister Curationis - MCur
Crispin, Vivianne. "Information exchange between patients and nurses during routine nursing care in ward settings : a qualitative multiple case study." Thesis, University of Stirling, 2014. http://hdl.handle.net/1893/21158.
Повний текст джерелаSpivey, Justin, Heather Sirek, Robert Wood, Kalpit Devani, Billy Brooks, and Jonathan Moorman. "Retrospective Cohort Study of the Efficacy of Azithromycin Vs. Doxycycline as Part of Combination Therapy in Non-Intensive Care Unit Veterans Hospitalized with Community-Acquired Pneumonia." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/3177.
Повний текст джерелаBaldini, Sonia Maria. "Avaliação das reações dos pais à internação do filho em unidade de terapia intensiva e desenvolvimento de uma proposta de apoio psicológico." Universidade de São Paulo, 2002. http://www.teses.usp.br/teses/disponiveis/5/5141/tde-01062007-111724/.
Повний текст джерелаObjectives: Assessment of parents reactions to the admission of their child into an ICU and development of a proposal of psychological support. Sample: 48 interviewed parents in pediatric ICU and 27 in neonatal ICU were included besides the participants of the groups of parents. Procedures: 1) Semi-directed interviews were performed with parents, with the application of previously elaborated questionaires; 2) Assessment of the parents anxiety at the admission of the child in ICU, with the application of the State-Trait Anxiety Inventory; and 3) lead groups of parents were performed in pediatric ICU with the participation of multidisciplinary staff. Results: The most frequent reactions cited by the parents to the admission of the child in an ICU were despair and sadness. Moreover, psychological support was the most essencial need at that moment. The most important feelings cited during hospitalization were worry, fear and sadness, and most parents in both ICU were very scared of the appearance of their children. There was a significant increase in parents anxiety at the admission of the child, and there were no differences between the scores of parents anxiety in pediatric or neonatal ICU. The group of parents was a good technique of psychological support in ICU. Conclusions: Psychological support to parents of pediatric patients admitted to an ICU is necessary, because of high anxiety level, dispair and sadness that parents show at the admission of their child to an ICU. The semi-directed interviews with the appication of the proposed questionaires to the assessment of parents were good techiques for the investigation of the emotional state of these parents and constituted efficient ways of giving them psychological support. The group of parents permitted the direct contact with professionals of various areas, willing to listen to them, value them, understand their feelings and clarify their doubts. They permitted contact with other parents in different phases of the same situation, mobilizing resources for dealing with the critical period of the disease and admission, and giving support in the mourning process of the healthy child so that they could get a satisfactory attachment to the sick one. The subject of death, the difficulties with the staff, the lack of support from relatives and other highly anxious questions could be discussed during the group sessions widely, bringing clarity and relief. The meetings with the staff after the group sessions were very important to unify the procedures, understand the parents reactions, and discuss the relationship between them and the staff. In relation to the individual semi-directed interviews, the parents group revealed a complementary technique, as the same problems and complaints were discussed in different ways in both forms of intervention.
Lee, Chin-Ling, and 李佳玲. "Characteristics of Hospital Medical Care Cost --- Inpatient Chemotherapy for Example." Thesis, 2005. http://ndltd.ncl.edu.tw/handle/21631354947566364170.
Повний текст джерела臺中健康暨管理學院
健康管理研究所
93
Motive: Control of medical expense has always been a tough issue faced by developed countries altogether. A variety of payment system set up aims to effectively reduce the increase of medical expense. Cancer has been in the rank of ten major cause of death for several years. Thus, the ratio of medical expense for cancer treatment has been relatively high in the proportion of healthcare medical budget. In particular, according to the list recording the total ratio of individual inpatients, the frequency of cancer inpatients admitted and receiving chemotherapy ranks top four in the year of 90. Hence, proper and reasonable distribution on medical expense is a crucial subject to work on. Nevertheless, different hospitals implement their own management system, which may generate variations on the approaches of medical expense control. Purpose: The purpose of this study aims to discuss the condition in terms of how medical resources of chemotherapy are utilized while different cancer inpatients receive treatment from different hospitals with their own hospital characters. Subjects and Method: The participants of this study include cancer inpatients of lung cancer, breast cancer, and rectum cancer. The researcher, based on the number of times these cancer inpatients admitted to the hospitals and received chemotherapy, analyze and discuss the utilization of medical resources among various hospitals with different characters. T-test, ANOVA, and multiple regression are used as statistical measures. Results: The results show that age of cancer inpatients and degree of illness result into different utilization of medical resources. Provided that cancer inpatients, who suffer from higher degree of illness, stay more days in the hospital, it can cause the increase of such utilization. Moreover, presented from the study, the type, ownership, and regions of the hospitals generate influence on medical treatment expense. In terms of hospital type, the expense of medical center is apparently higher than that of the hospitals of other type. As for ownership, the expense varies due to different types of cancer disease. However, it is also shown that provided that clinics have evidence-based medical as guidelines, the characters of hospitals would not influence doctor’s behaviors. Hence, under such circumstance, the consistency of medical resource utilization is relatively high.
De, la Rey Ella Stefani. "Attachment styles of children in an inpatient ward of a psychiatric hospital." Diss., 2006. http://hdl.handle.net/2263/23906.
Повний текст джерелаDissertation (MA(Psychology))--University of Pretoria, 2007.
Psychology
unrestricted
Ang, Neo Kim Emily. "Patient falls in acute care inpatient hospitals : a portfolio of research related to strategies in reducing falls." 2008. http://hdl.handle.net/2440/48333.
Повний текст джерелаhttp://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1321300
Thesis (D.Nurs.) -- University of Adelaide, School of Population Health and Clinical Practice, 2008
Ang, Neo Kim Emily. "Patient falls in acute care inpatient hospitals : a portfolio of research related to strategies in reducing falls." Thesis, 2008. http://hdl.handle.net/2440/48333.
Повний текст джерелаThesis (D.Nurs.) -- University of Adelaide, School of Population Health and Clinical Practice, 2008
Emerson, P. "Inpatient catchment populations of public sector hospitals in Natal/KwaZulu." Thesis, 1988. http://hdl.handle.net/10413/7620.
Повний текст джерелаThesis (M.Med.)-University of Natal, Durban, 1988.
AbuDagga, Azza. "A multilevel analysis of organizational and market predictors of patient assessments of inpatient hospital care." 2009. http://etda.libraries.psu.edu/theses/approved/WorldWideIndex/ETD-4111/index.html.
Повний текст джерела張湘怡. "The female nurses' space experiences in inpatient care units of Changhua christian hospital in Taiwan." Thesis, 2006. http://ndltd.ncl.edu.tw/handle/75803059950273492997.
Повний текст джерела