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Biomedical subjects

C A Walleck

Publications and source records attributed to C A Walleck.

11 recordsLinked to original sources
PubMed1994

Nursing and labor cost reduction.

The coming of healthcare reform requires healthcare providers and hospitals to rethink the goals and objectives of the healthcare delivery system of the United States. To lower increasing costs while preserving the ultimate quality of care is a tremendous challenge. Labor costs in health care are primary targets for cost-cutting. Professional nurses, the group of healthcare providers who take up most of the hospital budget, are being targeted in many settings as an expendable budget item. Critical care physicians and patients depend on professional nurses to meet the care needs in the ICU. Creative, innovative, cost-effective methods of delivering critical care services must be developed in order to meet the demands of an increasing patient population. Some trial models with the explicit goal of managing cost and delivering high-quality critical care are discussed.

Budgets↗
PubMed1993

Rationing health care. Impact on critical care.

Critical care practitioners are faced with ethical dilemmas every day. The increasing costs of health care coupled with the scarcity of resources, including critical care nurses, have created yet another ethical dilemma--rationing of health care. Rationing of critical care is occurring today and current conditions indicate that these decisions will become an increasing issue in the delivery of critical care services. This article identifies some of the ethical issues associated with the rationing of critical care and examines the foundations of ethical thought upon which such decisions can be based. Understanding the overall cost containment movement as well as the potential problems associated with medical gatekeeping will allow critical care practitioners to better deal with the ethical dilemmas of today as well as help them anticipate those that will arise in the near future.

Cost Control↗
PubMed1992

Preventing secondary brain injury.

Traumatic brain injury affects approximately 500,000 persons each year. For those patients who survive until they reach the hospital, the major goal of the health care team is to prevent secondary injuries or insults that may follow the initial event and worsen the brain injury. Factors that can cause secondary insults to the brain include hypoxia, hypercapnia, hypotension, and intracranial hypertension. Prevention of these factors begins in the pre-hospital care phase and continues into the critical care unit. Early recognition of these factors and prompt intervention can improve the neurologic outcome of the patient with severe head injury. An understanding of the causes and effects of these secondary insults is critical to the appropriate medical and nursing management of these patients.

Brain Injuries↗
PubMed1991

Building the framework for dealing with ethical issues.

Making ethical decisions is difficult. Professional and personal values enter heavily into what one member of the health care team considers the "right" decision, and these values may interfere with the decision-making process of the team. As team members begin to realize how their ethical values affect the decision, they may be better able to resolve the conflict within the team. An understanding of each member's ethics and values also can serve to enhance decision making. Nurses are just beginning to view themselves as part of the ethical decision-making team. In order to take an ethical stance, nurses need to have a better understanding of ethical principles to use in the decision-making process. Nurse needs to develop a sound philosophical base in ethics through study and continuing education to be an active part of the health care team making ethical decisions. Nurses have an obligation to move away from the emotional response to ethical dilemmas toward using a more sound basis for these decisions.

Attitude of Health Personnel↗
PubMed1990

Neurologic considerations in the critical care phase.

The critical care phase of spinal cord injury includes basic physiologic support of the cardiovascular and respiratory systems, as well as attempts to combat secondary effects of the injury. Critical care management is also aimed at preventing the complications of this devastating injury. Research has turned its focus to improving the neurologic outcome for these patients and the use of new pharmacologic agents will hopefully meet this goal in the near future. The critical care nurse is the most important component in meeting the goals of critical care management. Continued assessment and monitoring of the patient and appropriate nursing interventions are critical to allow the patient the best chance for optimal recovery.

Critical Care↗
PubMed1989

Controversies in the management of the head-injured patient.

The management of the patient with severe head injury has changed dramatically and continues to evolve. Through clinical studies on head-injured patients, the effectiveness of some current therapies are being questioned. Modifications of current protocols will continue to be made so that the overall goal of maintaining cellular integrity and preventing secondary injury to the brain can be met. As research continues, more changes are anticipated in the care of head injuries. The critical care nurse must keep abreast of the current trends in head injury management. No one can be sure what the future of head trauma care will be, but it is certain that it will change based on the effectiveness of the therapies on reducing mortality and morbidity for these patients.

Clinical Protocols↗
PubMed1983

Ethical dimensions of nursing practice.

Nurses are often called upon to participate in ethical decision-making. As the dimensions of nursing care increase, this role will also increase. This article has provided some strategies by which the nurse can come to an independent, personal decision; understand why the stance was chosen; and articulate the rationale for the choice to others. Obviously, this article is not meant to provide the sole groundwork for ethical decision-making, but rather an impetus for the practicing nurse to seek more information on ethics and the ethical dimensions of her own practice. Resolving ethical dilemmas will never be easy; however, by utilizing the theories and models presented here, the nurse can contribute to a responsible ethical decision. The Blackfoot Indian tribe has a philosophy regarding ethical choice that seems appropriate: "Everything is neither right nor wrong. The right or wrong is in the choosing, the keeping, the losing. All paths are light and shadow, and every path is a different thing to each man. The right and the wrong, the good and the evil lie not upon the silent pathway, but in the man that walks it..."

Decision Making↗