Education of Physicians-in-Training Can Decrease the Risk for Vascular Catheter Infection
Article Abstract:
Encouraging medical students and residents to use a full-size sterile drape when inserting a central venous catheter can lower the rate of catheter-related infections. Researchers gave a one-day infection control course to third-year medical students and interns from six intensive care units. Following the course, 73% understood the need for full-size sterile drapes, compared to 22% before the training. Sixty-five percent used the drape, compared to 44% before the training. The rate of catheter-related infection dropped 28% after the training.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 2000
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Pulse oximetry monitoring outside the intensive care unit: progress or problem?
Article Abstract:
Pulse oximetry monitors are devices that can measure the level of oxygen saturation in the blood through a probe that is clipped to a patient's fingertip. When the amount of oxygen in the blood falls below a certain level, an alarm sounds, permitting recognition of a potentially dangerous situation, and correction of it, if possible. Pulse oximetry was initially used in the operating room, but as its potential for monitoring patients' oxygen supplies on a continual basis has been recognized, its use has spread to intensive care units and general floors. As the use of pulse oximetry has spread, questions have been raised about its cost effectiveness. A study was performed to determine how frequently the information generated by the use of pulse oximetry resulted in a meaningful change in a patient's therapy. Observations were made on 40 patients who had pulse oximetry monitoring on a general medical floor. The number of times the pulse oximeters showed dangerously low levels of oxygen was recorded, and then compared with the number of times such oximetry readings resulted in action by the physicians and nurses. At least one episode of low oxygen levels was noted in 30 of the 40 patients. Seldom were these episodes noted by the nurses, and never by the physicians unless the nurses had noticed first. Changes in the care of the patients with low oxygen levels were only made in 26 percent of cases. Thus, while bedside pulse oximetry appears to have potential benefit in identifying possible dangerous low oxygen levels, in reality, the information garnered by the pulse oximeter rarely results in meaningful changes in therapy. Because pulse oximetry cost the hospital in which the study was performed over $250,000 for a single year, its present utilization does not seem to justify its use. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1991
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Mechanical Ventilation in a Cohort of Elderly Patients Admitted to an Intensive Care Unit
Article Abstract:
A study undertaken in response to the argument that life support for the elderly should be limited due to costs, found that elderly patients spent similar time on mechanical ventilation and in the intensive care unit (ICU) but had a lower cost of care than younger patients. This was the result of analysis of the in-hospital mortality rate, the length of time on mechanical ventilation, the lengths of stay in the ICU and hospital, and the cost of care for 63 patients age 75 and up and 237 patients under age 75 age randomly chosen from medical and coronary ICUs.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1999
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