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Nurse, surgery, medication, treatment, cost

Alireza K Nazemi, Anirudh K Gowd, Jonathan J Carmouche, Stephen L Kates, Todd J Albert, Caleb J Behrend
STUDY DESIGN: This study is a systematic review. OBJECTIVE: Propose an evidence-based algorithm for prevention, diagnosis, and management of postoperative delirium in geriatric patients undergoing elective spine surgery. SUMMARY OF BACKGROUND DATA: Delirium is associated with longer stays after elective surgery, increased risk of readmission, and $6.9 billion annually in medical costs. Early diagnosis and treatment of delirium can reduce length of stay (LOS), in-hospital morbidity, and health care costs...
April 2017: Clinical Spine Surgery
Anne Lanceley, Carlo Berzuini, Matthew Burnell, Sue Gessler, Stephen Morris, Andy Ryan, Jonathan A Ledermann, Ian Jacobs
OBJECTIVE: The aim of the study was to perform a preliminary comparison of quality of life (QoL) and patient satisfaction in individualized nurse-led follow-up versus conventional medical follow-up in ovarian cancer. METHODS: One hundred twelve women who received a diagnosis of ovarian, fallopian tube, or peritoneal cancer, completed primary treatment by surgery alone or with chemotherapy, irrespective of outcome with regard to remission, and expected survival of more than 3 months...
January 2017: International Journal of Gynecological Cancer
Veronica Chorro-Mari, Nanna Christiansen
AIM: Due to national changes to the commissioning process of high cost nebulisers (HCN) for Cystic Fibrosis (CF) patients, CF centres have to repatriate the prescribing of the HCN to the tertiary care centres.1 The following nebulisers will no longer be prescribed by primary care: Cayston® (Aztreonam); Colomycin®, Pomixin®, Clobreathe® (Colistimethate); Pulmozyme® (Dornase alfa); Tobi®, Tobi Podhaler ®, Bramitob® (Tobramycin).This abstract explains how the Royal London Hospital (RLH) Paediatric Pharmacy recruited over 100 paediatric (CF) patients smoothly within a period of 4 months and set up a homecare system to avoid patients and families having to travel large distances to obtain their medication...
September 2016: Archives of Disease in Childhood
Igor Koncar, Slobodan Cvetković, Marko Dragas, Sinisa Pejkić, Goran Lazović, Igor Banzić, Marinko Zuvela, Miroslav Marković, Lazar Davidović
UNLABELLED: BACKGROUND/AIM. Surgical and chronic wounds in vascular patients might contribute to limb loss and death. Vacuum-assisted closure (VAC)--Kinetic Concepts, Inc. (KCI), has been increasingly used in Western Europe and the U.S.A. clinical practice for 15 years. Advantages of this method are faster wound healing, wound approximation, lower wound related treatment costs and improved quality of life during treatment. Evidence related to the usage of VAC therapy in vascular patients and cost effectiveness of VAC therapy in a developing country are lacking...
January 2016: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
Deepti Kukreja, Ulf Günther, Julius Popp
Delirium is an acute disorder of attention and cognition seen relatively commonly in people aged 65 yr or older. The prevalence is estimated to be between 11 and 42 per cent for elderly patients on medical wards. The prevalence is also high in nursing homes and long term care (LTC) facilities. The consequences of delirium could be significant such as an increase in mortality in the hospital, long-term cognitive decline, loss of autonomy and increased risk to be institutionalized. Despite being a common condition, it remains under-recognised, poorly understood and not adequately managed...
December 2015: Indian Journal of Medical Research
P T P W Burgers, M Hoogendoorn, E A C Van Woensel, R W Poolman, M Bhandari, P Patka, E M M Van Lieshout
UNLABELLED: The aim of this study was to determine the total medical costs for treating displaced femoral neck fractures with hemi- or total hip arthroplasty in fit elderly patients. The mean total costs per patient at 2 years of follow-up were €26,399. These results contribute to cost awareness. INTRODUCTION: The absolute number of hip fractures is rising and increases the already significant burden on society. The aim of this study was to determine the mean total medical costs per patient for treating displaced femoral neck fractures with hemi- or total hip arthroplasty in fit elderly patients...
June 2016: Osteoporosis International
Ali Bikmoradi, Behnam Masmouei, Mohammad Ghomeisi, Ghodratollah Roshanaei
BACKGROUND AND AIMS: Coronary artery bypass graft is a major surgery and has complications that require professional and long term follow-up and nursing care that if do not properly handled, could reduce the quality of life and increase post-operative complications. On the other hand Tele-nursing is a cost-effective way to educate and follow-up of patients. This study aimed to assess the impact of Tele-nursing on adherence to treatment plan in discharged patients after coronary artery bypass graft...
February 2016: International Journal of Medical Informatics
Elena Nicod, Timothy L Jackson, Federico Grimaccia, Aris Angelis, Marc Costen, Richard Haynes, Edward Hughes, Edward Pringle, Hadi Zambarakji, Panos Kanavos
PURPOSE: The direct cost to the National Health Service (NHS) in England of pars plana vitrectomy (PPV) is unknown since a bottom-up costing exercise has not been undertaken. Healthcare resource group (HRG) costing relies on a top-down approach. We aimed to quantify the direct cost of intermediate complexity PPV. METHODS: Five NHS vitreoretinal units prospectively recorded all consumables, equipment and staff salaries during PPV undertaken for vitreomacular traction, epiretinal membrane and macular hole...
November 2016: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
Hiroyuki Shibata
Many diagnostic and treatment modalities for bone metastasis are available. They include biomarker examination, imaging techniques, surgery, radiation therapy, chemotherapy, palliation, and rehabilitation, among others. Diagnosis of the disease and administration of these treatments require caregivers and other medical personnel including medical oncologists for primary tumors, radiologists, pathologists, orthopedists, radiotherapists, palliative care doctors, rehabilitation doctors, dentists, nurses, pharmacists, physical therapists, psychologists, and medical social workers...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Annemieke Oude Lansink-Hartgring, Berber van den Hengel, Wim van der Bij, Michiel E Erasmus, Massimo A Mariani, Michiel Rienstra, Vladimir Cernak, Karin M Vermeulen, Walter M van den Bergh
OBJECTIVES: To conduct an exploration of the hospital costs of extracorporeal life support therapy. Extracorporeal life support seems an efficient therapy for acute, potentially reversible cardiac or respiratory failure, when conventional therapy has been inadequate, or as bridge to transplant, but unfortunately, no evidence in randomized controlled trials is delivered yet. DESIGN: Single-center retrospective exploratory cohort cost study. The study is performed from a hospital perspective with a time horizon of patients' complete hospital admission in which they received extracorporeal life support...
April 2016: Critical Care Medicine
Matthew K Whalin, Matthias Kreuzer, Kevin M Halenda, Paul S García
PURPOSE: Postoperative delirium is a common and costly state of brain dysfunction that complicates postsurgical management in some patients. The purpose of this report was to describe a case of prolonged postoperative delirium and to review the appropriate identification and management of this condition. METHODS: A 56-year-old female patient who presented with newly diagnosed diabetes mellitus and dry gangrene underwent a vascular bypass procedure while under general anesthesia...
December 1, 2015: Clinical Therapeutics
G Pron
BACKGROUND: Magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU) is a noninvasive uterine-preserving treatment alternative to hysterectomy for women with symptomatic uterine leiomyomas (fibroids). Uterine fibroids commonly occur, have a broad impact on women's health and lifestyle, continue to be the main indication for hysterectomy, and represent a costly public health burden. OBJECTIVES: The objectives of the analysis were to evaluate patients' eligibility for MRgHIFU treatment of symptomatic uterine fibroids and the technical success, safety, effectiveness, and durability of this treatment...
2015: Ontario Health Technology Assessment Series
Yushan Jiang, Stephen Resch, Xiaoxia Liu, Selwyn O Rogers, Reza Askari, Michael Klompas, Sudha P Jayaraman
BACKGROUND: Our institution had an outbreak of multi-drug-resistant Acinetobacter (MDRA) in 2011. We analyzed the costs of responding to this outbreak from the hospital's perspective. METHODS: We estimated retrospectively the excess costs associated with an MDRA outbreak response at a major academic medical center, including the costs of staffing, supplies, administrative time, deep cleaning, and environmental testing. Differences in mean costs before and during the 2011 MDRA outbreak were analyzed using the Student t-test...
February 2016: Surgical Infections
Sandrine Baffert, Huong Ly Hoang, Anne Brédart, Bernard Asselain, Séverine Alran, Hélène Berseneff, Cyrille Huchon, Caroline Trichot, Aline Combes, Karine Alves, Martin Koskas, Thuy Nguyen, Aurélie Roulot, Roman Rouzier, Delphine Héquet
BACKGROUND: A care pathway is defined as patient-focused global care that addresses temporal (effective and coordinated management throughout the illness) and spatial issues (treatment is provided near the health territory in or around the patient's home). Heterogeneity of the care pathways in breast cancer (BC) is presumed but not well evaluated. The OPTISOINS01 study aims to assess every aspect of the care pathway for early BC patients using a temporal and spatial scope. METHODS/DESIGN: An observational, prospective, multicenter study in a regional health territory (Ile-de-France, France) in different types of structures: university or local hospitals and comprehensive cancer centers...
2015: BMC Cancer
Shanglong Liu, Yanbing Zhou
Fast track surgery is referred as the integration of different medical intervention actively during peri-operative period to accelerate the rehabilitation of patients undergoing operation. The propose of fast track surgery has brought about great changes in the treatment mode of many diseases, and the concept has been used in a variety of operations, especially the gastrointestinal surgery. Fast track surgery covers the preoperative appropriate preparation and assessment, sophisticated operative manipulation, and the standardization of postoperative treatment and nursing care...
February 2015: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Sudeep J Karve, Gregory L Price, Keith L Davis, Gerhardt M Pohl, Emily Nash Smyth, Lee Bowman
BACKGROUND: Limited data exist regarding real-world treatment patterns, resource utilization, and costs of extensive-stage small cell lung cancer (esSCLC) among elderly patients in the United States. While abundant data are available on treatment patterns in metastatic non-small cell lung cancer (mNSCLC), to our knowledge no data exist comparing costs and resource use between patients with esSCLC or mNSCLC. METHODS: We retrospectively analyzed administrative claims data (2000-2008) of patients aged ≥65 years from the linked Surveillance, Epidemiology and End Results (SEER)-Medicare database...
2014: BMC Health Services Research
A-K Bräscher, J Blunk, S Söhle, R E Feldmann, M Bauer, J Benrath
BACKGROUND: Besides reliable efficacy and patient satisfaction, economic efficiency is becoming increasingly more important in postoperative pain management. AIM: The present study investigated the effectiveness of two pain pump systems and compared the running costs in treatment. MATERIAL AND METHODS: In this study 40 patients received an interscalene catheter prior to shoulder surgery. Postoperative pain management was provided via an electronic pump with patient-controlled analgesia (PCA) or a mechanical pump without PCA...
October 2014: Der Anaesthesist
M Muhm, M Walendowski, T Danko, C Weiss, T Ruffing, H Winkler
BACKGROUND: In departments of orthopedic and trauma surgery patients with proximal femoral fractures constitute the largest proportion of trauma patients. The length of stay (LOS) has economic consequences and prolonged LOS leads to a shortage in bed capacity. OBJECTIVES: In this study treatment and patient-related factors that influence the LOS of patients with proximal femoral fractures were investigated. MATERIAL AND METHODS: Treatment and patient-related data of 242 patients (age >64 years) were recorded retrospectively and included residential aspects, legal guardianship, time of admission and surgery, hospital mortality, LOS, diagnosis, comorbidities, medication, surgical treatment, general and surgical complications, intensive care therapy and American Society of Anesthesiologists (ASA) classification...
July 2016: Der Unfallchirurg
Qian Gu, Lane Koenig, Richard C Mather, John Tongue
BACKGROUND: A hip fracture is a debilitating condition that consumes significant resources in the United States. Surgical treatment of hip fractures can achieve better survival and functional outcomes than nonoperative treatment, but less is known about its economic benefits. QUESTIONS/PURPOSES: We asked: (1) Are the societal benefits of hip fracture surgery enough to offset the direct medical costs? (2) Nationally, what are the total lifetime benefits of hip fracture surgery for a cohort of patients and to whom do these benefits accrue? METHODS: We estimated the effects of surgical treatment for displaced hip fractures through a Markov cohort analysis of patients 65 years and older...
November 2014: Clinical Orthopaedics and related Research
Jayer Chung, J Gregory Modrall, Chul Ahn, Lawrence A Lavery, R James Valentine
BACKGROUND: This study was conducted to quantify the effect of multidisciplinary care (MDC) on amputation-free survival (AFS) and wound healing within a chronic critical limb ischemia (CLI) population. METHODS: We performed a retrospective, single-center cohort study of consecutive CLI patients presenting to the Vascular Surgery Service. Patients who received initial and follow-up wound care from the MDC were compared with patients who received standard wound care (SWC)...
January 2015: Journal of Vascular Surgery
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