A volunteer-based Hospital Elder Life Program to reduce delirium.

A community hospital with nearly 50% of its admitted patients 70 years or older adapted the well-established Hospital Elder Life Program (HELP). The primary adaptation entailed an enhanced participation of trained volunteers in HELP interventions designed to prevent and reduce delirium. Integral program elements include detailed volunteer training, required demonstration of competencies, and regular evaluation and feedback of volunteers provided by program staff.

Assessing adequate treatment response in patients with rheumatoid arthritis.

Background: Rheumatoid arthritis (RA) presents a substantial socioeconomic burden that is potentially reduced by individualized, appropriate management strategies. Integral to such strategies is recognizing the need for treatment changes when patients inadequately respond or do not respond to treatment. However, there might be little or no agreement as to what constitutes treatment failure or an adequate response.

Enoxaparin dosing in the elderly using adjusted body weight.

We prospectively compared anti-Xa activity in 61 elderly (>65 years) subjects receiving enoxaparin according to standard or adjusted body weight (ABW) dosing. In the ABW dosing group, mean patient age was 76 years, mean weight 80 kg, mean serum creatinine 1.0 mg/dl, and mean CrCl 48 ml/min.

After the fact: the case for posttransaction antitrust review of health plan mergers.

When health insurance administrators contemplate mergers or consolidations of their plans, the transactions are generally subject to federal or state antitrust review. Regulators have traditionally examined proposed transactions for their posttransaction market power and the anticipated operating efficiencies and then decided whether to permit the transaction. Given the somewhat speculative nature of preand posttransaction market power and efficiency projections, antitrust policymakers should consider allowing the mergers or consolidations of health insurance plans to proceed while regulators subject the process to posttransaction review and enforcement.

Post-diagnostic cardiac catheterization: development and evaluation of an evidence-based standard of care.

The purpose of this article is to describe one process for the development and evaluation of an evidence-based standard of care for inpatients undergoing a diagnostic cardiac catheterization. As the volume of cardiac catheterizations increases, with more high-risk patients and with new methods to achieve hemostasis, an evidence-based standard of care for the post-diagnostic cardiac catheterization patient needs to be developed to ensure positive clinical outcomes. Clinical educators are in a position to affect nursing practice and can provide the impetus for implementing evidence-based standards of care.

Integrating patient questionnaire data into electronic medical records.

Electronic medical records allow the quick and easy incorporation of data into the medical records. By virtue of their design, questionnaire responses can be entered and used in the electronic environment with little or no effort on the part of the practicing physician. Data can be captured through various means, stored, and then viewed when the patient visits the office.

Emergency nurses' knowledge of evidence-based ischemic stroke care: a pilot study.

Introduction: The purpose of this pilot study was to assess emergency nurses' knowledge of evidence-based ischemic stroke care.

Design And Methods: A descriptive, correlational design was used. Emergency nurses (N = 20) working in 2 hospitals in the Mid-Atlantic region completed a 10-item multiple choice test on evidence-based ischemic stroke care.

Post-anesthesia care unit nurses' knowledge of pulse oximetry.

The purpose of this study was to assess post-anesthesia care unit (PACU) nurses' knowledge of pulse oximetry. A convenience sample of 19 nurses completed a 32-item questionnaire that included a 20-item true-false test on pulse oximetry. Overall, nurses demonstrated a knowledge deficit in pulse oximetry.

Stop the spinning: diagnosing and managing vertigo.

Differentiating vertigo from other forms of dizziness presents a diagnostic challenge. Extensive investigation, however, can help reveal vertigo's true etiology: life-threatening central lesions or debilitating, but benign, peripheral causes. Here, learn to assess vertigo using physical examination, history, and diagnostic procedures.

Relationship between benign prostatic hyperplasia and history of coronary artery disease in elderly men.

Study Objective: To assess the relationship between the occurrence of benign prostatic hyperplasia (BPH), an androgen-dependent disease, and coronary artery disease (defined as history of coronary artery bypass grafting, coronary angioplasty, myocardial infarction) in elderly men.

Design: Retrospective chart review.

Setting: Urology practice.

Polydactyly in the pre-adolescent foot: an unusual case presentation with impending pathologic fracture.

Polydactyly of the foot is a common congenital deformity. The authors report a case of postaxial polydactyly with impending pathological fracture. Successful surgical correction was performed with an uneventful 10-month follow-up.

A new way of thinking: how managed care networks will affect physician and hospital marketing efforts.

The formation of integrated delivery networks will cause physicians and hospitals to rethink their marketing strategies. As providers align themselves into networks in conjunction with managed care plans, new approaches to marketing will be employed.

Clinical guidelines: a defense in medical malpractice suits.

Clinical pathways, or practice guidelines, have been gaining wider acceptance from physicians and hospitals seeking to constrain increasing operating costs for inpatient care. The authors believe that properly developed and agreed upon guidelines can also be used in certain cases as appropriate standards of care in determining if medical malpractice has occurred. Adherence to the guidelines could then be asserted by defendants as an affirmative defense in a medical malpractice suit.

Making hospital advertisements more readable and more effective.

Hospitals and other health care organizations make continuing use of newspaper and magazine advertising as part of their marketing programs. However, many institutions have questioned the effectiveness of advertising because they have not achieved the results they had hoped for. Part of the problem may lie in the fact that many hospital advertisements violate the principles of good copywriting.