Therapy associated with treatment-related anemia continues to be of great concern for health care providers. Patient satisfaction, patient adherence, and growing insurance reimbursement concerns ...related to Epoetin alpha therapy for anemia initiated the development of a nursing-led process improvement team at New York University (NYU) Medical Center. Multiple patient groups were identified and treated for anemia with Epoetin alpha through the guide of a standardized pathway providing a convenient and effective treatment plan. The treatment delivery had to be consistent with institutional reimbursement requirements while avoiding significant cost to the patient. Patient populations diagnosed with HIV anemia, HIV oncology, presurgical anemia, and medically complex anemia can now receive appropriate ambulatory treatment. This article describes the formation of the "Epo-Depot" and the logistics involved to service these patients with anemia.
Implementing a Geriatric Resource Nurse Model Lopez, Marilyn; Delmore, Barbara; Ake, Jean M. ...
The Journal of nursing administration,
11/2002, Letnik:
32, Številka:
11
Journal Article
Recenzirano
The aging of the American population and its effects on healthcare centers require strategies and programs to ensure best practices for older patients. The authors describe an educational program, ...modification of a Geriatric Resource Nurse Model, and the use of a Geriatric Nurse Practitioner in implementing and integrating the clinical, psychosocial, and financial aspects that influence care needed by elderly patients and their families.
The study addresses two conditions that afflict long-term ventilated adult patients during the weaning process: fatigue and protein calorie malnutrition. The majority of the study was conducted in a ...four-bed respiratory unit of a tertiary care, urban medical center over 15 months. Sixty-one patients were assessed non-randomly for the study. Of the 61 patients, 45 were disqualified and five were removed from the study. The 11 remaining patients were able to complete the protocol. Fatigue scores were measured using the numerical rating scale of the Lee Fatigue Scale and protein calorie malnutrition was measured using serum prealbumin levels. Levine's Principles of Conservation (energy and structural integrity) guided the analysis for the longitudinal, descriptive design of this study. Findings revealed that LTV patients had distinctive fatigue trends during the weaning course. Fatigue scores were lower in the morning and rose after a weaning trial. Certain factors affected fatigue trends. Patients having a rest period before a weaning trial and during a weaning trial helped to reduce fatigue. Findings revealed an inverse relationship between fatigue and energy as would be expected during the weaning process. Overall, patients in the study experienced moderate to severe fatigue and low to moderate energy throughout their entire weaning process. PAB levels did not have a statistically significant association with fatigue; however, emerging trends were noted on particular patients who had subnormal to critically low PAB levels. Essentially, “morning” fatigue levels rose as PAB levels dropped and lowered as PAB levels rose. Likewise, “morning” energy levels lowered as PAB levels dropped and raised as PAB levels rose.
Timing is essential for survival and reproduction of organisms across the tree of life. The core circadian clock gene Clk is involved in the regulation of annual timing events and shows highly ...conserved sequence homology across vertebrates except for one variable region of poly-glutamine repeats. Clk genotype varies in some species with latitude, seasonal timing and migration. However, findings are inconsistent, difficult to disentangle from environmental responses, and biased towards high latitudes. Here we combine field data with a common-garden experiment to study associations of Clk polymorphism with latitude, migration and annual-cycle timing within the stonechat species complex across its trans-equatorial distribution range. Our dataset includes 950 records from 717 individuals from nine populations with diverse migratory strategies. Gene diversity was lowest in resident African and Canary Island populations and increased with latitude, independently of migration distance. Repeat length and annual-cycle timing was linked in a population-specific way. Specifically, equatorial African stonechats showed delayed timing with longer repeat length for all annual-cycle stages. Our data suggest that at low latitudes with nearly constant photoperiod, Clk genotype might orchestrate a range of consistent, individual chronotypes. In contrast, the influence of Clk on annual-cycle timing at higher latitudes might be mediated by its interactions with genes involved in (circadian) photoperiodic pathways.
