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Marta L Render

Publications and source records attributed to Marta L Render.

20 records · Page 2Linked to original sources

Anthropometric and pulmonary function test profiles of outpatients with stable chronic obstructive pulmonary disease.

PURPOSE: To determine the prevalence of abnormalities in the nutritional status, and their correlation with pulmonary function test results, in a population of outpatients with stable chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS: During 1 year of study, body weight, height, triceps skinfold, arm muscle circumference, and pulmonary function parameters were assessed in 126 patients. On the basis of body mass index (BMI = weight/height2) of less than 20, 20 to 27, and greater than 27, the patients were divided into underweight (n = 29, 23%), normal weight (n = 67, 53.2%), and overweight (n = 30, 23.8%), respectively. RESULTS: Diffusing capacity for carbon monoxide (DLCO), both as absolute and percent predicted, differed significantly among the three groups, being lowest in the underweight and highest in the overweight patients. A significant and positive correlation was present between BMI as the independent variable and DLCO, forced expiratory volume in 1 second, and its ratio to forced vital capacity. A significant and negative correlation existed between BMI and residual volume and its ratio to total lung capacity. CONCLUSION: A substantial number of stable COPD patients (46.8%) have nutritional abnormalities. BMI is a simple and accurate indicator of nutritional status in these patients. BMI correlates significantly with some tests of pulmonary function.

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Improving patient safety by identifying side effects from introducing bar coding in medication administration.

OBJECTIVE: In addition to providing new capabilities, the introduction of technology in complex, sociotechnical systems, such as health care and aviation, can have unanticipated side effects on technical, social, and organizational dimensions. To identify potential accidents in the making, the authors looked for side effects from a natural experiment, the implementation of bar code medication administration (BCMA), a technology designed to reduce adverse drug events (ADEs). DESIGN: Cross-sectional observational study of medication passes before (21 hours of observation of 7 nurses at 1 hospital) and after (60 hours of observation of 26 nurses at 3 hospitals) BCMA implementation. MEASUREMENTS: Detailed, handwritten field notes of targeted ethnographic observations of in situ nurse-BCMA interactions were iteratively analyzed using process tracing and five conceptual frameworks. RESULTS: Ethnographic observations distilled into 67 nurse-BCMA interactions were classified into 12 categories. We identified five negative side effects after BCMA implementation: (1) nurses confused by automated removal of medications by BCMA, (2) degraded coordination between nurses and physicians, (3) nurses dropping activities to reduce workload during busy periods, (4) increased prioritization of monitored activities during goal conflicts, and (5) decreased ability to deviate from routine sequences. CONCLUSION: These side effects might create new paths to ADEs. We recommend design revisions, modification of organizational policies, and "best practices" training that could potentially minimize or eliminate these side effects before they contribute to adverse outcomes.

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