Biomedical subjects

P B Daly

Publications and source records attributed to P B Daly.

8 recordsLinked to original sources

PubMed1993

Patient-focused care: key principles to restructuring.

Patient-focused care (PFC) is a unique patient care delivery model that is becoming more popular in today's hospitals. Bishop Clarkson Memorial Hospital in Omaha, Nebraska, was one of the first hospitals to implement PFC. Clarkson used four principles to guide its pilot unit implementation--grouping similar patient populations, moving services closer to the patient, broadening staff skills, and simplifying processes. The four principles and their implementation are described; preliminary results are reported.

Attitude of Health Personnel↗

PubMed1992

Infection and immune response in the elderly.

A number of immunologic functions have been shown to decline in an age-related fashion, particularly cell-mediated immunity and antibody response to an immunogen. Underlying degenerative diseases and medications further contribute to the immunologic abnormalities noted in the elderly. The elderly in hospitals and nursing homes are a particularly vulnerable subset, with a high incidence of institutionally acquired infection. Aspects of disease prevention in the elderly are discussed.

Aged↗

PubMed1992

Impact on knowledge and practice of a multiregional long-term care facility infection control training program.

BACKGROUND: Few affordable training opportunities are specifically designed for the long-term care facility infection control practitioner. There is also little evidence of the success of training in improving infection control practices. The Nebraska Infection Control Network developed a 2-day basic skills training program for Midwestern long-term care facility infection control practitioners that was later disseminated to eastern and western training sites. In this study we examined the effectiveness of the training program in terms of trainee knowledge and practice. METHODS: From 1986 to 1990, a total of 17 courses conducted at the three sites were attended by a total of 266 infection control practitioners. Trainees completed a 40-item multiple choice test before and after training to evaluate their knowledge gain. Implementation of eight key infection control practices and time devoted to infection control duties were measured before training and at 3 and 12 months after training. Implementation of infection control practices was also evaluated in a second study, with infection control practitioners randomly assigned to trained and wait-control conditions. RESULTS: Significant increases after training were found at each site for both knowledge and implementation measures. These increases were maintained at 12 months follow-up. Time devoted to infection control duties increased significantly at the midwest and western sites but not at the eastern site. In the second study, significant differences were found between the trained and the wait-control group in use of infection control practices, providing evidence for a causal relationship between training and increased use of practices. CONCLUSIONS: The training program was effective in producing improvements in knowledge and implementation of recommended infection control practices in long-term care facilities. These improvements were consistent across three diverse geographic areas. There were some specific geographic differences.

California↗

PubMed1992

Design and dissemination of a multiregional long-term care infection control training program.

Long-term care facilities have only recently begun to receive attention in the area of infection control. A training program was developed in Nebraska to help supply practitioners with knowledge and techniques designed specifically for the long-term care environment. This program's success led to its implementation in other regions. The regional extensions of the program were designed to operate with independent faculty but standardized course materials.

Cross Infection↗

PubMed1992

In vivo evaluation of enteric-coated naproxen tablets using gamma scintigraphy.

Seven healthy, male volunteers were entered into a randomized, open crossover study of the gastrointestinal transit of two enteric-coated 500-mg naproxen tablets. Two radiolabeled tablets were given to each volunteer on two occasions separated by 7 days, once in the fasted state and once after breakfast. Radiolabeling of tablets was achieved by the incorporation of samarium-152 oxide during manufacture, followed by neutron activation of the tablet to produce the gamma-emitting isotope samarium-153. No loss of tablet integrity was seen in the stomach and all tablets disintegrated in the small intestine. Onset of tablet disintegration was controlled predominantly by gastric emptying. Time in the small intestine prior to tablet disintegration was independent of food intake. Naproxen blood levels with time were consistent with the delayed release of naproxen from the tablets. Overall, transit, disintegration, and absorption were as expected from an enteric-coated tablet.

Adult↗

PubMed1991

Current status of nosocomial infection control in extended care facilities.

The 1980s saw the birth and growth of the distinct field of infection control in the extended care facility (ECF). Major advances in the field during the last decade have been surveys documenting the magnitude of the problem of ECF nosocomial infections, descriptive studies of ECF nosocomial infections, descriptive studies of ECF epidemics, development of ECF infection control programs, and recognition of the unique problems of the ECF infection control program. As the field matures, areas that should receive additional attention during the upcoming decade include: analysis of the risk factors and consequences of ECF nosocomial infections; analysis of resident and institutional variables that predict nosocomial infection; and studies on the efficacy of both infection control programs and specific infection control measures. ECF infection control programs have benefited a great deal from hospital infection control, but ECF infection control problems are quite different and demand unique solutions.

Cross Infection↗

PubMed1991

A microbiologic survey of long term care urinary catheters.

Culture and sensitivity data were collected on over 500 isolates from indwelling urinary catheters in 23 Nebraska long-term care facilities. Four percent of all nursing home patients had indwelling urinary catheters. The prevalence of bacteriuria in catheterized patients was 79%., and the most frequent isolates were E. coli, Proteus mirabilis, and Enterococcus species. Thirteen percent of catheterized patients were receiving systemic antibiotics, and 85% had at least one urinary bacterial isolate resistant to the antibiotic being administered. Antibiotic resistance correlated positively with a number of factors in the long-term care institutions, including size and skill level.

Aged↗

PubMed1991

Home-based immunoglobulin infusion therapy: quality of life and patient health perceptions.

Thirty-seven antibody-deficient patients who were participating in a multicenter trial evaluating home-based, self-administered IVIG therapy anonymously completed questionnaires regarding beliefs concerning health control, quality of life, and attitudes toward active participation in medical care. Their responses were compared with a group of 29 patients undergoing traditional IVIG therapy in a medical clinic setting. A subsample of the home-based group who later returned to clinic-based IVIG therapy allowed comparison of responses given by the same patients in both settings. Home-based therapy was preferred to clinic-based therapy. Independence, convenience, comfort, decreased disruption of activities, travel time, and costs were specific factors rated most favorably. On the Health Belief Questionnaires, patients preferred informed, self-involved medical care regardless of the setting for their IVIG treatments.

Adult↗