What you need to know about consumer-directed home care.

Consumerism, a significant catalyst for change in healthcare, is challenging many traditional home care concepts. This article reviews the consumer-directed home care model as piloted by numerous Medicaid programs and examines its basis in current research. Additional examples of the impact of consumerism on the Medicare program as well as nontraditional, emerging services are presented.

Where is the theory to support infusion nursing?

Even though there has been a dramatic increase in both the type and number of nursing theories, the infusion nursing specialty remains without a theoretical base. This article addresses the need for and types of infusion nursing theory. The obstacles to theory development, including the theory-practice gap in nursing, are examined in terms of their relevance to the infusion specialty.

Revising outcome measures for an established pathway.

In 1996, the orthopedic multidisciplinary team of Columbia (MO) Regional Hospital developed and implemented a clinical pathway for total knee replacement.

Computer-assisted instruction: MR imaging of the knee.

Computer-assisted education offers a unique method of learning that is complementary to conventional learning techniques. The regional anatomy of musculoskeletal magnetic resonance (MR) imaging lends itself well to discrete learning modules on the computer. This article describes a computer-assisted educational program for MR imaging of the knee.

An evaluation of the susceptibility patterns of gram-negative organisms isolated in cancer centres with aminoglycoside usage.

This study in 12 cancer treatment centres across the United States was designed to evaluate the potential for increased resistance to amikacin with unrestricted use. An initial 3-month baseline period during which the use of amikacin was restricted and that of tobramycin and gentamicin unrestricted was followed by a period of at least 12 months when amikacin was the primary aminoglycoside. Resistance of Gram-negative bacilli to these aminoglycosides from hospitalized patients was monitored and compared for the two periods.

Three-dimensional compensating filters using magnetic resonance images.

A technique for making radiation therapy compensators for missing tissue using magnetic resonance imaging (MRI) is presented. Magnetic resonance imaging was chosen for its ability to provide easily visible, accurate patient contours at any treatment angle. Phantom studies, including coronal cuts of a 45-degree phantom, showed that distortion in the magnetic resonance imaging is minimal, but that the image magnification should be checked by placing markers on the patient during the procedure.