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Biomedical subjects

M E Orr

Publications and source records attributed to M E Orr.

6 recordsLinked to original sources
PubMed1995

High tech home care: surviving and prospering in a changing environment.

Managed care plans are expanding rapidly into new marketplaces. Reimbursement for home infusion therapy, including parenteral and enteral nutrition, is significantly affected under managed care, especially when capitated payment mechanisms are used. Home care companies have experienced downsizing, mergers, acquisitions, and fierce competition in the managed care environment. Clinicians who are entering the home care setting may find that, in addition to clinical expertise, their marketability depends on a set of new skills and abilities in order to prosper in this new environment.

Home Care Services↗
PubMed1993

Vascular access devices: perspectives on designs, complications, and management.

The use of vascular access devices in hospitalized and home care patients has expanded rapidly in the past decade. New designs, materials, insertion techniques, and protocols for care related to vascular access devices have emerged. Complications associated with them, however, have remained a persistent problem. Septicemia, thrombosis, and occlusion are three of the more serious complications that can lead to the need for removal of the device. These complications are reviewed and areas for future research are identified.

Catheters, Indwelling↗
PubMed1993

Issues in the management of percutaneous central venous catheters. Single and multiple lumens.

In this era of high technology and extensive parenteral therapies, multiple-lumen CVCs seem to be among the many devices needed to provide appropriate care to hospitalized patients. All CVCs, regardless of their benefit, create substantial risks for mechanical and septic complications. Antibacterial solutions that are bonded to the catheter and longer-acting skin antiseptics offer preliminary evidence that CVC sepsis rates can be reduced. The advances in CVC design, materials, and coatings are intended to be a supplement to--not a substitute for--meticulous care of CVCs.

Anti-Infective Agents, Local↗
PubMed1989

Nutritional support in home care.

Nutritional support was among the first of the high-tech therapies to make the transition from hospital to home. Growth in high-tech home care accelerated in the mid-1980s, following establishment of the prospective payment system. Rapid growth in home care continues amid acquisitions and mergers of home care companies. The HPN and HEN populations have both enlarged and evolved with time, and the current populations mirror changes in health care demographics--showing the largest increases in services to the elderly. Changes have occurred in the types of venous and enteral access devices, infusion systems, parenteral and enteral products, and infusion schedules used by HPN and HEN patients. As therapies have caused less disruption in patients' lifestyles and as services have become more widely available, adaptation to HPN and HEN has become somewhat less difficult. However, patients still report concerns over finances, respite services, and symptoms management. Nurses have a primary role in the preparation of patients for home nutritional support and in the provision of home care services. Nursing research can illuminate the unique contribution of nurses to safe, cost effective, and high quality home nutritional support.

Catheterization, Central Venous↗