Establishing and achieving team-based organization performance measures.
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Biomedical subjects
N Michels
Publications and source records attributed to N Michels.
The transition from hospital to home: an exploratory study.
With the predominance of the elderly and chronically ill, and shorter lengths of stay, hospitals struggle with facilitating timely discharge while ensuring that the patient and family receive proper ongoing care. Subsequently, facilitating the patient's smooth transition from hospital is of primary importance at the time of discharge. Yet, little is known about the situations and difficulties patients experience during the first week after discharge. This study explored the patient's transition from hospital to home. Using a random sample of adult medical-surgical patients, data was collected during the first week at home using telephone and in-depth interviews, and participant observation. The results of this study present four major themes: the nature of the patient's continuing care needs, the importance of an available and able caregiver, the presence of caregiver uncertainty, and the need for information. In addition, it identified home care services as a vital resource to assist patients with illness management. Further research is needed to examine the patient's transition home over time, to explore the importance of caregiver networks and information seeking after discharge, and to develop discharge planning methods which integrate hospital and community services.
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Electroencephalogram investigations of the disequilibrium syndrome during bicarbonate and acetate dialysis.
Continuous long-time electroencephalographic (EEG) monitoring was performed during acetate and bicarbonate dialysis in 20 patients. Persisting normal basic activity of the EEG without neurological symptoms was found only during the course of bicarbonate dialysis. However, in acetate dialysis, during the decrease of arterial CO2 tension (PaCO2), we registered EEG disturbances with moderate to severe slowing, dysrhythmic activity and high voltage discharges. The decrease in PaCO2 and the deterioration in EEG activity in the patients during acetate dialysis was concomitant with severe neurological alterations, e.g. the typical symptoms of so-called 'disequilibrium' causing a cessation of dialysis in three patients.
Acetates↗
[Electro-encephalographic study of the disequilibrium syndrome during bicarbonate dialysis and acetate dialysis].
Continuous long-time electroencephalographic (EEG) monitoring was performed during AHD and BHD in 20 patients. Persisting normal basic activity of the EEG without neurological symptoms could be found only during the course of BHD. However, in AHD, during the decrease of arterial CO2 tension (PaCO2) we registered EEG disturbances with moderate to severe slowing down, dysrythmic activity and high voltage discharges. The decrease in PaCO2 and the deterioration in EEG activity in the patients during AHD was concomitant with severe neurological alterations, e.g. the typical symptoms of so-called "disequilibrium" causing a cessation of dialysis in 3 patients.
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