Biomedical subjects

Michael R Silver

Publications and source records attributed to Michael R Silver.

4 recordsLinked to original sources

PubMed2006

Improving outcomes: focus on workplace issues.

PURPOSE OF REVIEW: Staff satisfaction has not traditionally been included as an intensive care unit quality indicator. The process of providing intensive care may profoundly affect clinicians. Dysfunctional encounters with coworkers and ethical burdens may extract a considerable personal toll and affect work attitudes and performance. RECENT FINDINGS: Mounting evidence indicates that psychosocial tensions, burnout and ethical stress are common and serious problems in the intensive care unit. These experiences impact negatively on job satisfaction, turnover, workplace disruption and patient care. Addressing workplace issues will help improve quality of care. SUMMARY: Two common sources of staff dissatisfaction are examined. Improving staff satisfaction can improve unit performance, and serve to attract and retain quality clinicians.

Burnout, Professional↗

PubMed2005

Acute lung injury induced by arsenic trioxide in a patient with refractory myelodysplastic syndrome.

Arsenic trioxide has been used successfully for the treatment of refractory acute promyelocytic leukemia and has shown promise in the treatment of myelodysplastic syndrome (MDS), although it is not a labeled indication. Retinoic acid syndrome is manifested by fever, dyspnea, peripheral edema, pulmonary infiltrates, and pleural and/or pericardial effusions and is typically seen in conjunction with all- trans retinoic acid therapy of acute promyelocytic leukemia. We report a case of acute lung injury and a retinoic acid syndrome-like illness in a patient who received arsenic for MDS. To our knowledge, this is the first such report, and clinicians should be aware of this potentially life-threatening complication of arsenic trioxide treatment in patients with MDS.

Aged↗

PubMed2005

Anemia in the long-term ventilator-dependent patient with respiratory failure.

Anemia occurs in virtually all critically ill patients receiving long-term mechanical ventilation and has been associated with increased mortality and poor outcomes. Allogeneic RBC transfusions are routinely administered to critically ill anemic patients, especially during lengthy stays in ICUs or in long-term acute care facilities. Although RBC transfusions are a physiologically rational approach to raising hemoglobin levels, they may increase the risk of complications and have been associated with higher mortality in critically ill patients. Treatment with epoetin alfa, an erythropoiesis-stimulating agent, as a means of reducing transfusion requirements has been studied in the critically ill and in patients receiving long-term mechanical ventilation. Promising results have been reported, including a potential survival benefit, although larger and more definitive studies are needed in order to establish whether raising hemoglobin levels affects clinical outcomes in patients receiving mechanical ventilation.

Anemia↗

PubMed2002

Patient safety: a tale of two systems.

Patient safety remains a major issue for health care delivery systems and the American public. One community hospital has kept pace with this issue using traditional quality management approaches. A national multihospital health care system has leveraged its electronic medical record system to facilitate data collection and analysis of events impacting patient safety. The article describes both approaches for addressing the complex issues surrounding patient safety.

Adverse Drug Reaction Reporting Systems↗