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B I Braun

Publications and source records attributed to B I Braun.

4 recordsLinked to original sources
PubMed1996

Developing an outcomes measurement system: the value of testing.

Outcomes measurement systems often experience similar challenges to implementing data collection and demonstrating value. This article examines the experiences of 451 hospitals participating in a 2-year research effort designed to assess the ability of participants to successfully implement collection of obstetric and peri-operative indicator data for development of an outcomes measurement system. Measures of ability to implement include rate of attrition and reasons for withdrawal, resources expended, months of data transmitted, internal factors that affected ability to operationalize data collection, and assessment of value of participating in the testing process. The findings indicate considerable variation in implementation ability, challenges encountered, and satisfaction with the experience. Several changes in the operational system were made in response to the findings. Many of the lessons learned from the testing experience may be applicable to sponsors of and participants in other outcomes measurement systems.

Anesthesia↗
PubMed1993

Can pharmacokinetic dosing decrease nephrotoxicity associated with aminoglycoside therapy.

A randomized, controlled clinical trial was performed to determine whether individualized dosing by use of Bayesian pharmacokinetic modeling could decrease nephrotoxicity accosted with aminoglycoside therapy. Two hundred forty-three patients receiving aminoglycosides for suspected or proven infection were randomly assigned to one of three groups: usual physician-directed dosing (Group 1), pharmacist-assisted dosing (Group 2), or pharmacist-directed dosing (Group 3). Dosing in Groups 2 and 3 was based on a Bayesian pharmacokinetic dosing program, whereas Group 1 served as the control group. Individualized dosing resulted in higher mean postinfusion (peak) serum aminoglycoside levels, higher ratios of mean peak level to minimum inhibitory concentration (peak/MIC ratios), and a trend toward lower trough serum levels. Milligrams per dose were higher and number of doses per day was lower in the pharmacist-dosed groups. However, the incidence of nephrotoxicity (> or = 100% increase in serum creatinine) was not different among the three groups (16, 27, and 16% in Groups 1, 2, and 3, respectively). Similarly, severity of toxicity was not affected by the dosing intervention. Risk factors for toxicity included duration of therapy, shock, treatment with furosemide, older age, and liver disease. After controlling for these factors, the dosing intervention still had no effect on nephrotoxicity. It was concluded that Bayesian pharmacokinetic dosing did not decrease the risk of nephrotoxicity associated with aminoglycoside therapy.

Aged↗
PubMed1991

The effect of nursing home quality on patient outcome.

This historical cohort study investigated the relationship between nursing home quality and the group outcomes of mortality, rehospitalization, and discharge. Multiple logistic regression was used to determine if nursing home quality indices increased the prediction of these outcomes when patient severity of illness and case-mix differences were in the model. Three hundred ninety veterans discharged to 11 nursing homes were followed for 6 months. Nursing home quality was assessed using indices from the Multiphasic Environmental Assessment Procedure and the Rush-Medicus Methodology for Monitoring Quality of Nursing Care. An increased likelihood of death was associated with the diagnoses of cancer and heart disease and with being rehospitalized. Four nursing home quality indices significantly improved the prediction of mortality (RN hours, nursing process, security, and mean quality). Rehospitalization was associated with the patient factors of heart disease, hypertension, race, and level of care and with size of the nursing home. Discharge from the facility was inversely associated with the diagnosis of cancer and directly related to the index of nursing process. The results support the notion that group outcomes may be related to nursing home quality and suggest the need for further studies to investigate the specific elements of nursing home quality which relate to improved outcome.

Adult↗