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809. Modified Laboratory Reporting to Prevent Catheter-Associated Urinary Tract Infections (CAUTIs). Open Forum Infect Dis 2020. [PMCID: PMC7776741 DOI: 10.1093/ofid/ofaa439.999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Catheter-associated urinary tract infections (CAUTIs) are among the most common healthcare-associated infections. Many patients at our institution with a CAUTI do not have signs or symptoms of infection and bacterial growth likely represents asymptomatic bacteriuria (ASB). As a result, we implemented a Modified Lab Workflow (MLW) focused on diagnostic stewardship to improve urine culture (UCx) reporting and prevent misclassification and unnecessary treatment of CAUTIs. Methods On Sep. 1, 2019, laboratory reporting of Foley UCx was modified according to the protocol in Figure 1. UCx results were divided into 3 groups: (1) no growth, (2) mixed bacterial flora (≥3 organisms) not consistent with infection or (3) growth of ≤2 organisms with at least 1 organism ≥105 cfu/ml per National Healthcare Safety Network (NSHN) CAUTI definition. Group 3 UCx were resulted with instructions to the clinician (see Figure 1.). When requested, group 3 results were reviewed by Infection Prevention and released with organism identification and antibiotic susceptibility if it met Infectious Diseases Society of America (IDSA) CAUTI criteria. Otherwise they were resulted as: “Bacterial growth indicative of contamination or colonization.” Figure 1. Modified Laboratory Workflow for Reporting Urine Cultures from Foley Catheters ![]()
Results Between Sep. 1, 2019 to Mar. 1, 2020, a total of 134 UCx from catheterized patients were reviewed. Forty-two (31%) of UCx were from patients with a Foley in-situ ≥48 hours and processed through MLW; 92 UCx were from a Foley in place < 48 hours and excluded from the study. Of the 42 UCx processed via MLW, 16 (38%) were no growth and 7 (17%) had bacterial growth suggestive of contamination. For group 3, 19/42 (45%) had growth of significant bacteria but only 1(5%) met IDSA criteria for reporting. During the study, 6 additional CAUTIs were reported due to incorrect specimen labeling causing Foley urine specimens to subvert MLW. Conclusion During our study, we identified 1 CAUTI through apt MLW use. Seven total CAUTIs occurred (SIR=0.66); a majority due to incorrect UCx source labeling, resulting in missed MLW screening. Ten CAUTIs (SIR=0.97) were reported in the preceding 6 months. As part of a comprehensive CAUTI prevention program, a MLW can help reduce classification of ASB as a CAUTI. Education to providers on precise labeling of UCx source is a key component of a successful MLW. Disclosures All Authors: No reported disclosures
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Regional Spread of an Outbreak of Carbapenem-Resistant Enterobacteriaceae Through an Ego Network of Healthcare Facilities. Clin Infect Dis 2019; 67:407-410. [PMID: 29415264 DOI: 10.1093/cid/ciy084] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 02/01/2018] [Indexed: 01/26/2023] Open
Abstract
Background In 2013, New Delhi metallo-β-lactamase (NDM)-producing Escherichia coli, a type of carbapenem-resistant Enterobacteriaceae uncommon in the United States, was identified in a tertiary care hospital (hospital A) in northeastern Illinois. The outbreak was traced to a contaminated duodenoscope. Patient-sharing patterns can be described through social network analysis and ego networks, which could be used to identify hospitals most likely to accept patients from a hospital with an outbreak. Methods Using Illinois' hospital discharge data and the Illinois extensively drug-resistant organism (XDRO) registry, we constructed an ego network around hospital A. We identified which facilities NDM outbreak patients subsequently visited and whether the facilities reported NDM cases. Results Of the 31 outbreak cases entered into the XDRO registry who visited hospital A, 19 (61%) were subsequently admitted to 13 other hospitals during the following 12 months. Of the 13 hospitals, the majority (n = 9; 69%) were in our defined ego network, and 5 of those 9 hospitals consequently reported at least 1 additional NDM case. Ego network facilities were more likely to identify cases compared to a geographically defined group of facilities (9/22 vs 10/66; P = .01); only 1 reported case fell outside of the ego network. Conclusions The outbreak hospital's ego network accurately predicted which hospitals the outbreak patients would visit. Many of these hospitals reported additional NDM cases. Prior knowledge of this ego network could have efficiently focused public health resources on these high-risk facilities.
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Notes from the Field: Large Cluster of Verona Integron-Encoded Metallo-Beta-Lactamase-Producing Carbapenem-Resistant Pseudomonas aeruginosa Isolates Colonizing Residents at a Skilled Nursing Facility - Chicago, Illinois, November 2016-March 2018. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2018; 67:1130-1131. [PMID: 30307908 PMCID: PMC6181260 DOI: 10.15585/mmwr.mm6740a6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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What are the Gaps in Reprocessing and Sterilization Practices in Illinois Healthcare Settings? A Summary of Observations in 56 Illinois Settings, 2016-2017. Am J Infect Control 2018. [DOI: 10.1016/j.ajic.2018.04.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Identifying Opportunities for Targeted Interventions: Gaps in Endocavity Probe High-Level Disinfection Practices Across Healthcare Settings in Illinois. Am J Infect Control 2018. [DOI: 10.1016/j.ajic.2018.04.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Prolonged and large outbreak of invasive group A Streptococcus disease within a nursing home: repeated intrafacility transmission of a single strain. Clin Microbiol Infect 2018; 25:248.e1-248.e7. [PMID: 29783026 DOI: 10.1016/j.cmi.2018.04.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 04/19/2018] [Accepted: 04/30/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Multiple invasive group A Streptococcus (GAS) infections were reported to public health by a skilled nursing facility (facility A) in Illinois between May 2014 and August 2016. Cases continued despite interventions including antibiotic prophylaxis for all residents and staff. Two other geographically close facilities reported contemporaneous outbreaks of GAS. We investigated potential reasons for ongoing transmission. METHODS We obtained epidemiologic data from chart review of cases and review of facility and public health records from previous investigations into the outbreak. Infection control practices at facility A were observed and evaluated. Whole genome sequencing followed by phylogenetic analysis was performed on available isolates from the three facilities. RESULTS From 2014 to 2016, 19 invasive and 60 noninvasive GAS infections were identified at facility A occurring in three clusters. Infection control evaluations during clusters 2 and 3 identified hand hygiene compliance rates of 14% to 25%, appropriate personal protective equipment use in only 33% of observed instances, and deficient wound-care practices. GAS isolates from residents and staff of all three facilities were subtype emm89.0; on phylogenetic analysis, facility A isolates were monophyletic and distinct. CONCLUSIONS Inadequate infection control and improper wound-care practices likely led to this 28-month-long outbreak of severe infections in a skilled nursing facility. Whole genome sequencing and phylogenetic analysis suggested that intrafacility transmission of a single highly transmissible GAS strain was responsible for the outbreak in facility A. Integration of genomic epidemiology tools with traditional epidemiology and infection control assessments was helpful in investigation of a facility-wide outbreak.
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Management of Outbreaks of Methicillin-ResistantStaphylococcus aureusInfection in the Neonatal Intensive Care Unit: A Consensus Statement. Infect Control Hosp Epidemiol 2016; 27:139-45. [PMID: 16465630 DOI: 10.1086/501216] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2005] [Accepted: 08/18/2005] [Indexed: 01/23/2023]
Abstract
Objective.In 2002, the Chicago Department of Public Health (CDPH; Chicago, Illinois) convened the Chicago-Area Neonatal MRSA Working Group (CANMWG) to discuss and compare approaches aimed at control of methicillin-resistantStaphylococcus aureus(MRSA) in neonatal intensive care units (NICUs). To better understand these issues on a regional level, the CDPH and the Evanston Department of Health and Human Services (EDHHS; Evanston, Illinois) began an investigation.Design.Survey to collect demographic, clinical, microbiologic, and epidemiologic data on individual cases and clusters of MRSA infection; an additional survey collected data on infection control practices.Setting.Level III NICUs at Chicago-area hospitals.Participants.Neonates and healthcare workers associated with the level III NICUs.Methods.From June 2001 through September 2002, the participating hospitals reported all clusters of MRSA infection in their respective level III NICUs to the CDPH and the EDHHS.Results.Thirteen clusters of MRSA infection were detected in level III NICUs, and 149 MRSA-positive infants were reported. Infection control surveys showed that hospitals took different approaches for controlling MRSA colonization and infection in NICUs.Conclusion.The CANMWG developed recommendations for the prevention and control of MRSA colonization and infection in the NICU and agreed that recommendations should expand to include future data generated by further studies. Continuing partnerships between hospital infection control personnel and public health professionals will be crucial in honing appropriate guidelines for effective approaches to the management and control of MRSA colonization and infection in NICUs.
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The Infection Control Assessment and Response Tool: Is It Useful during an Outbreak? Am J Infect Control 2016. [DOI: 10.1016/j.ajic.2016.04.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Clinical Outcomes of Carbapenem-Resistant Acinetobacter baumannii Bloodstream Infections: Study of a 2-State Monoclonal Outbreak. Infect Control Hosp Epidemiol 2015; 31:1057-62. [DOI: 10.1086/656247] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective.To characterize the clinical outcomes of patients with bloodstream infection caused by carbapenem-resistant Acinetobacter baumannii during a 2-state monoclonal outbreak.Design.Multicenter observational study.Setting.Four tertiary care hospitals and 1 long-term acute care hospital.Methods.A retrospective medical chart review was conducted for all consecutive patients during the period January 1, 2005, through April 30, 2006, for whom 1 or more blood cultures yielded carbapenem-resistant A. baumannii.Results.We identified 86 patients from the 16-month study period. Their mortality rate was 41%; of the 35 patients who died, one-third (13) had positive blood culture results for carbapenem-resistant A. baumannii at the time of death. Risk factors associated with mortality were intensive care unit stay, malignancy, and presence of fever and/or hypotension at the time blood sample for culture was obtained. Only 5 patients received adequate empirical antibiotic treatment, but the choice of treatment did not affect mortality.Fifty-seven patients (66.2%) had a single positive blood culture result for carbapenem-resistant A. baumannii; the only factor associated with a single positive blood culture result was the presence of decubitus ulcers. Interestingly, during the study period, a transition from single to multiple positive blood culture results was observed. Four patients, 3 of whom were in a burn intensive care unit, were bacteremic for more than 30 days (range, 36–86 days).Conclusions.To our knowledge, this is the first time a study has described 2 patterns of bloodstream infection with A. baumannii: single versus multiple positive blood culture results, as well as a subset of patients with prolonged bacteremia.
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Identification, Management, and Clinical Characteristics of Hospitalized Patients with Influenza-Like Illness during the 2009 H1N1 Influenza Pandemic, Cook County, Illinois. Infect Control Hosp Epidemiol 2015; 32:998-1002. [DOI: 10.1086/661912] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective.To describe the identification, management, and clinical characteristics of hospitalized patients with influenza-like illness (ILI) during the peak period of activity of the 2009 pandemic strain of influenza A virus subtype H1N1 (2009 H1N1).Design.Retrospective review of electronic medical records.Patients and Setting.Hospitalized patients who presented to the emergency department during the period October 18 through November 14, 2009, at 4 hospitals in Cook County, Illinois, with the capacity to perform real-time reverse-transcriptase polymerase chain reaction testing for influenza.Methods.Vital signs and notes recorded within 1 calendar day after emergency department arrival were reviewed for signs and symptoms consistent with ILI. Cases of ILI were classified as recognized by healthcare providers if an influenza test was performed or if influenza was mentioned as a possible diagnosis in the physician notes. Logistic regression was used to determine the patient attributes and symptoms that were associated with ILI recognition and with influenza infection.Results.We identified 460 ILI case patients, of whom 412 (90%) had ILI recognized by healthcare providers, 389 (85%) were placed under airborne or droplet isolation precautions, and 243 (53%) were treated with antiviral medication. Of 401 ILI case patients tested for influenza, 91 (23%) had a positive result. Fourteen (3%) ILI case patients and none of the case patients who tested positive for influenza had sore throat in the absence of cough.Conclusions.Healthcare providers identified a high proportion of hospitalized ILI case patients. Further improvements in disease detection can be made through the use of advanced electronic health records and efficient diagnostic tests. Future studies should evaluate the inclusion of sore throat in the ILI case definition.
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Clostridium difficile outbreak strain BI is highly endemic in Chicago area hospitals. Infect Control Hosp Epidemiol 2012; 32:897-902. [PMID: 21828970 DOI: 10.1086/661283] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Describe the clinical and molecular epidemiology of incident Clostridium difficile infection (CDI) cases in Chicago area acute healthcare facilities (HCFs). DESIGN AND SETTING Laboratory, clinical, and epidemiologic information was collected for patients with incident CDI who were admitted to acute HCFs in February 2009. Stool cultures and restriction endonuclease analysis typing of the recovered C. difficile isolates was performed. PATIENTS Two hundred sixty-three patients from 25 acute HCFs. RESULTS Acute HCF rates ranged from 2 to 7 patients with CDI per 10,000 patient-days. The crude mortality rate was 8%, with 20 deaths occurring in patients with CDI. Forty-two (16%) patients had complications from CDI, including 4 patients who required partial, subtotal, or total colectomy, 3 of whom died. C. difficile was isolated and typed from 129 of 178 available stool specimens. The BI strain was identified in 79 (61%) isolates. Of patients discharged to long-term care who had their isolate typed, 36 (67%) had BI-associated CDI. CONCLUSIONS Severe disease was common and crude mortality was substantial among patients with CDI in Chicago area acute HCFs in February 2009. The outbreak-associated BI strain was the predominant endemic strain identified, accounting for nearly two-thirds of cases. Focal HCF outbreaks were not reported, despite the presence of the BI strain. Transfer of patients between acute and long-term HCFs may have contributed to the high incidence of BI cases in this investigation.
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Parents as a vector for nosocomial infection in the neonatal intensive care unit. Infect Control Hosp Epidemiol 2001; 22:472. [PMID: 11700866 DOI: 10.1086/503404] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
We compared class I surgical-site infection (SSI) rates for new and experienced surgeons. Data showed that new surgeons in two surgical subspecialties associated with higher baseline SSI rates had rates higher than their experienced colleagues. They took longer in the operating room (OR), but did not operate on sicker patients. As the surgeons gained more experience (as measured by cumulative cases), their OR times and SSI rates decreased toward their colleagues'. New surgeons who perform infection-prone surgery may have higher SSI rates than more experienced colleagues until they gain experience. A new surgeon's SSI rate could be one factor considered in assessing competence.
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Facilitating factors for, barriers to, and outcomes of interdisciplinary education projects in the health sciences. JOURNAL OF ALLIED HEALTH 2001; 29:165-70. [PMID: 11026119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Appropriate collaboration and communication among health professionals is viewed as increasingly important in meeting the challenges of today's health care system. Student socialization to interdisciplinary practice is thought to be facilitated through interdisciplinary academic and clinical learning experiences during the educational program. The purpose of this article is to identify factors commonly cited as facilitating and inhibiting interdisciplinary education, to provide insight for the development of successful interdisciplinary education projects.
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Abstract
OBJECTIVE There is widespread public dissemination of research findings and media messages regarding social advantages of physical attractiveness and liabilities of unattractiveness. The purpose of this experimental study was to determine the effects of such information on women's body-image experiences. METHOD College women (n = 66) listened to one of two audiotapes that detailed research-based information either on the subject of appearance stereotyping and discrimination or on the control topic of television violence and aggression. RESULTS Although the two conditions did not differentially alter mood, exposure to appearance-related versus control information produced significantly less favorable body-image evaluations. Furthermore, as predicted, women who were schematically invested in their physical appearance were especially susceptible to the deleterious effects of the appearance information. DISCUSSION The scientific and clinical implications of these findings were discussed, particularly with respect to eating disturbances.
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Interdisciplinary health professional education: a historical review. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2001; 6:25-47. [PMID: 11486138 DOI: 10.1023/a:1009875017951] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
A historical review was conducted to examine the advances made, nationally and internationally, in interdisciplinary health professional education since the mid-1960s. One hundred and nineteen articles were reviewed and divided by decade into the following subheadings: models, courses, communication/group process issues, and international perspectives. Twenty-seven articles, categorized as models, defined the conceptual field, described curriculum and program development, or provided a framework for evaluation. Thirty-two articles dealt with interdisciplinary courses, focusing on objectives, content areas, or innovative methods. Nine articles contributed content on interdisciplinary communication and group process issues, from which guidelines were abstracted. Fifty-one articles contributed an international perspective, leading to the recognition that interdisciplinary health professional education, practice, and research is a global movement.
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Words on standardized languages. Am J Nurs 2001; 101:13; author reply 14. [PMID: 11211681 DOI: 10.1097/00000446-200101000-00004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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A review of the use of nursing diagnosis in U.S. nurse practice acts. NURSING DIAGNOSIS : ND : THE OFFICIAL JOURNAL OF THE NORTH AMERICAN NURSING DIAGNOSIS ASSOCIATION 1999; 10:57-64. [PMID: 10633691 DOI: 10.1111/j.1744-618x.1999.tb00027.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine how many state nurse practice acts include the term or concept of "nursing diagnosis" and describe their similarities and differences. METHODS Investigators independently divided the practice acts of the 50 states and the District of Columbia into those that did or did not include the term "nursing diagnosis" or the word "diagnosis" within a nursing context. To describe other differences, the investigators operationally defined and independently categorized each act as trendsetting, contemporary, or traditional. FINDINGS Thirty-three of the 51 practice acts used the term "diagnosis" within nursing context. Of these 33, 13 were identified as trendsetters and 20 as contemporary. Seven trendsetting and 5 contemporary practice acts used the NANDA-based language or "response" when describing the "what" of nursing diagnosis. None of the trendsetting practice acts, but 8 of the contemporary acts, used the NANDA-based "individual, family or community" when describing the "who" of nursing diagnosis. CONCLUSIONS The language of nursing is changing. The majority of practice acts now define the practice of professional nursing as including the diagnostic act, although the manner in which they use the term varies.
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Patients' perceptions of uncertainty and stress during weaning from mechanical ventilation. Dimens Crit Care Nurs 1999; 18:8-12. [PMID: 10639993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
Weaning from mechanical ventilation is physiologically and psychologically stressful for patients. The critical care nurse is in an optimal position to reduce patients' stress during this process. The findings of this exploratory study suggest practice changes--based on patients' perspectives--that help reduce patients' feelings of uncertainty and stress as they are weaned from mechanical ventilation.
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Is there a future for nursing diagnosis? MCN Am J Matern Child Nurs 1998; 23:290-1. [PMID: 9819518 DOI: 10.1097/00005721-199811000-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Characteristics of patient visits to nurse practitioners and physician assistants in hospital outpatient departments. J Prof Nurs 1998; 14:335-43. [PMID: 9838757 DOI: 10.1016/s8755-7223(98)80075-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many authors have described differences between nurse practitioners and physician assistants. Most studies have compared physician with nonphysician providers' practice. Few studies have compared nurse practitioners and physician assistants, and none has used a national data base. This exploratory, atheoretical research examined which of the following characteristics predicted patients being seen by nurse practitioners and physician assistants: patient and hospital demographics, diagnosis, diagnostic/screening services, therapeutic services, and disposition of the visit. The data set used for analysis was the 1992 National Hospital Ambulatory Medical Care Survey. Based on a multistage probability design yielding national estimates for patient visits in hospital outpatient settings, the National Hospital Ambulatory Medical Care Survey showed that there were 2,847 weighted patient visits to either nurse practitioners or physician assistants (4.6 million patient visits using national estimates). Results of multivariate logistic regression suggest that nurse practitioners were the most likely nonphysician provider for outpatients receiving more health promotion and counseling (therapeutic) services and for those needing women's and children's services. Outpatients in rural areas predicted visits to physician assistants. As more nonphysician providers enter the work force, the results of this research may assist with understanding the utilization of nurse practitioners and physician assistants in primary care.
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Utilization of a classification of nursing diagnoses. NURSING DIAGNOSIS : ND : THE OFFICIAL JOURNAL OF THE NORTH AMERICAN NURSING DIAGNOSIS ASSOCIATION 1998; 9:17-26. [PMID: 9987311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Infection control "curbsides" from the community. Am J Infect Control 1998; 26:83-4. [PMID: 9503121 DOI: 10.1016/s0196-6553(98)70071-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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[Interview with Doctor Mary Ann Lavin. Interview by Cristina Francisco del Rey]. REVISTA DE ENFERMERIA (BARCELONA, SPAIN) 1996; 19:29-30. [PMID: 9070780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Classifying nursing diagnoses. Am J Nurs 1974; 74:250-3. [PMID: 4492217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Bed exercises for acute cardiac patients. Am J Nurs 1973; 73:1226-7. [PMID: 4488722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Cross-cultural identification and utilization of nursing approaches applicable to the delivery of health care. Int Nurs Rev 1973; 20:73-7 passim. [PMID: 4489125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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