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Biomedical subjects

E Shields

Publications and source records attributed to E Shields.

9 recordsLinked to original sources
PubMed1996

Fatal asphyxiations in children involving drawstrings on clothing.

Injuries account for more deaths and hospital admissions among children and adolescents than all diseases combined. The authors report two deaths by asphyxiation that resulted from drawstrings on the children's clothing becoming entangled on slides. Although such incidents are not common, they are preventable. The authors urge physicians to counsel parents and guardians to remove drawstrings from children's clothing, and they call upon the government and the clothing industry to work toward improving the safety standards for the design, manufacture and importation of children's clothing and banning the sale of children's clothing with drawstrings in Canada. In addition, they provide several resources for readers interested in helping reduce playground hazards in their communities.

Airway Obstruction↗
PubMed1995

Reflection and learning in student nurses.

One aim of the reforms in nurse education is to produce reflective practitioners. The researcher teaches in a diploma programme and decided to see if there was any evidence that students, one year into a Common Foundation Programme, were developing reflective skills or if they were learning through reflection. Students in this study value reflection as a means of learning and it seems that reflection has led to behaviour change, problem-solving and personal and professional awareness as well as improved patient care. They value debriefing following experience and there is evidence that they would benefit from training in mental previewing techniques prior to embarking on new experience.

Education, Nursing, Baccalaureate↗
PubMed1994

Improving the outcomes of coronary artery bypass surgery in New York State.

OBJECTIVE: To assess changes in outcomes of coronary artery bypass graft (CABG) surgery in New York since 1989, when the State Department of Health began collecting, analyzing, and disseminating information regarding risk factors, mortality, and complications of CABG surgery. These new data stimulated specific quality improvement activities at hospitals throughout the state. DESIGN: A clinical database was used to identify significant independent risk factors and to assess risk-adjusted provider mortality rates. SETTING: All 30 hospitals performing CABG surgery in New York during the period 1989 through 1992. PATIENTS: All 57,187 patients undergoing isolated CABG surgery who were discharged from New York State hospitals in 1989 through 1992. MAIN OUTCOME MEASURES: Actual, expected (from a logistic regression model), and risk-adjusted in-hospital mortality. RESULTS: Actual mortality decreased from 3.52% in 1989 to 2.78% in 1992. Because average patient severity of illness increased, risk-adjusted mortality decreased even more--a decrease of 41% from 4.17% in 1989 to 2.45% in 1992. The risk-adjustment model performed well; there were no clinically or statistically significant differences between actual and predicted numbers of deaths at any of 10 levels of patient severity. CONCLUSIONS: We believe that this quality improvement program, based on the collection and dissemination of risk-adjusted mortality data for CABG surgery, played a significant role in the observed decline in the death rate from this procedure. Quality improvement programs based on similar principles for other procedures and conditions should be undertaken.

Actuarial Analysis↗