53,963 research outputs found
Markov chain models for progression of breast cancer. Part I: tumour attributes and the preclinical screen-detectable phase
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Markov chain models for progression of breast cancer. Part II: prediction of outcomes for different screening regimes
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Estimation of mean sojourn time in breast cancer screening using a Markov chain model of both entry and exit from the preclinical detectable phase.
No full textAn Opiate Infusion Protocol for the Emergency Department: A Quality Improvement Project
No full textIn 2019, the Center for Disease Control and Prevention (CDC) reported there were 139 million Emergency Department (ED) visits in the United States, with abdominal pain accounting for five to ten percent of these visits (Kendall et al., 2020). With pain being a quality-of-care indicator, ED providers aim to decrease patients’ pain scores quickly while awaiting diagnostic results. However, the United States is currently experiencing an opioid epidemic that has resulted in increasing morbidity and mortality rates along with a rapidly growing financial burden. With no nationally recognized quality measures or best practices in place, ED providers are now faced with finding ways to manage their patients’ acute pain without worsening this epidemic. In 2001, a study was completed that determined a 15-minute morphine infusion achieved the drugs peak effect at roughly the same time as a two-minute morphine bolus, however sustained a peak effect for a longer duration of time (Marsch et al., 2001). While this study did not analyze pain levels in relation to the rate of morphine administration, it does offer opportunity for a quality improvement (QI) project. For this QI project, an algorithm for patients presenting to Covington Medical Center’s ED with complaints of abdominal pain was created. If opioids were deemed necessary according to the algorithm, ED providers were prompted to order a 15-minute morphine infusion rather than the two-minute bolus which is currently the standard practice. This project, which consisted of two phases that extended over an eight week period, aimed to determine if patients who receive a 15-minute morphine infusion have more adequate and sustained pain relief when compared to a two-minute morphine bolus
Addressing Post-Intensive Care Syndrome with Family-Centered Interventions
No full textThe advancements in medical technology and interventions has revolutionized the definition of a successful patient outcome. The traditional success of medical treatment was based on a patient’s ability to survive an illness. With a progressive application of evidence-based interventions and technological advances, researchers and healthcare providers are beginning to shift the measurement of positive healthcare outcomes on the long-term morbidity surrounding critical illness. Empirical research findings recognize the long-term consequences of intensive care treatment in the pediatric population. Severe psychological disorders, such as PTSD, depression and anxiety, is estimated to affect 20% of ICU survivors within 1 year of discharge. As a result of the interdependent relationship between a child and caregivers, family members frequently report psychological and emotional trauma as a result of their child’s critical illness. This can have a profound impact on a family’s quality of life, hence directly impacting the care and well-being of the child. Healthcare providers and parents play a pivot role in a child’s recovery path from a critical illness. Awareness of post-intensive care syndrome can allow for early recognition and interventions. The aim of the QI project was to provide education to healthcare team members on post-intensive care syndrome, implement an ICU diary pilot program and assess the usefulness of the diary. The education module demonstrates a significant gap in knowledge concerning post-intensive care syndrome in healthcare team members with a high receptibility. With increased awareness, the healthcare staff team can provide early interventions to decrease the prevalence and severity of PICS within the pediatric population. Diaries offer a cost-effective method of provided family-centered care that can potentially mitigate adverse psychosocial outcomes and improve long-term outcomes of caregivers of critically ill children
The relative contributions of screen-detected in situ and invasive breast carcinomas in reducing mortality from the disease
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