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Leapfrog Groups standards for critical care are not grounded sufficiently in evidence to mandate their stringent and universal implementation. Rather, most of the guidelines are grounded in common sense and rational extrapolation of the data. As such, they are a reasonable starting point for debate by physicians and policymakers about optimal methods of achieving intensivist-guided care of critically ill patients.
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No CT variables predicted severe in-hospital morbidity and mortality (death from pulmonary embolism, death from any cause, or cardiac arrest) in patients with PE. However, ventricular septal bowing and increased RV/LV diameter ratio were both strongly predictive of less severe morbidity, namely, subsequent ICU admission, and oligemia was associated with subsequent intubation and vasopressor use.
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Noninvasive positive-pressure ventilation (NPPV) was assessed in 105 patients with severe acute hypoxemic respiratory failure. The use of noninvasive positive pressure ventilation (NPPV) is effective to reduce intubation and mortality in patients with acute hypoxemic respiratory failure.
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In an analysis of important clinical outcomes after adjuvant chemotherapy for stage II and III colorectal cancer, Chau and colleagues from the United Kingdom reviewed the experiences of 530 patients. Of these, 154 relapsed with metastatic disease, local recurrence, or metachronous tumor.
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In a phase II trial of cetuximab (Erbitux) given once weekly to patients with advanced colorectal cancer who had failed prior irinotecan treatment, a modest response rate was observed and the toxicity profile was shown to be manageable.
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Imatinib was administered to newly diagnosed patients with chronic-phase myelogenous leukemia at a dose (800 mg daily) double what is commonly prescribed. Cytogenetic and molecular responses were significantly better than observed in an historical cohort of similar patients treated with 400 mg daily.
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Mirroring an overall trend in health care quality, employee safety increasingly is taking center stage for occupational health nurses, say the experts. And this trend is growing in two parallel directions: an expanding role for current occ-health nursing positions, as well as potential new job opportunities.
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Root cause analysis, long a popular tool for quality improvement initiatives, holds tremendous promise for occupational health professionals seeking to improve their disability management programs, says Jennifer Christian,MD, president and chief medical officer of Webility Corp. in Wayland, MA.
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Ergonomics is more than a way to lift patients. As Butler (PA) Memorial Hospital found, it can lift morale and employee satisfaction as well.
