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Biomedical subjects

Sidna M Scheitel

Publications and source records attributed to Sidna M Scheitel.

5 recordsLinked to original sources

Nurse-based telephone protocol versus usual care for management of URI and acute sinusitis: a controlled trial.

Two hundred and twelve patients with upper-respiratory-tract infection (URI) or sinusitis were treated using a nurse-based telephone protocol. This study evaluated the clinical outcomes and satisfaction of the patients compared with patients receiving usual care. For patients with URI, the rate of antibiotic administration was lower in the nurse-based telephone-treatment group (28% vs. 34%; P = .46), and for those with sinusitis, a greater proportion of the telephone treatment group received first-line antibiotics for the infection, compared with the usual care group (81% vs. 53%; P = .01). A guideline-based nurse telephone treatment protocol may decrease inappropriate use of antibiotics for URI and can result in a greater use of first-line antibiotics for patients with sinus infection with similar clinical outcomes.

Anti-Bacterial Agents↗

Recollection of previous colon cancer screening in Minnesota adults.

Regularly scheduled screening of patients has been shown to be effective for decreasing morbidity and mortality from colorectal cancer. We used a questionnaire to assess patients' ability to accurately recall the date and type of their most recent colorectal cancer screening. The study included 200 consecutive patients whose records indicated they had undergone previous colorectal cancer screening (8 patients were later excluded because they had been screened more than 5 years earlier). Overall, 32.3% of patients could not recall the date of their last colorectal cancer screening, 34.3% recalled the date inaccurately, and 33.3% recalled the date accurately within 1 month. The results suggest that recall alone is not sufficient to determine the date and type of previous colorectal cancer screening, especially if the screening was performed more than a year earlier.

Aged↗

Patient satisfaction with point-of-care international normalized ratio testing and counseling in a community internal medicine practice.

Point-of-care international normalized ratio (POC INR) testing is increasingly used to monitor anticoagulant therapy. This study assessed patient satisfaction with registered nurse--managed POC INR testing in a primary care internal medicine practice. One hundred eighty-seven of the first 216 (87%) patients using the program responded to the survey. The respondents were surveyed for satisfaction after they had experienced the nurse-managed POC INR system at the Mayo Clinic, Rochester, Minnesota, for one month. Eighty-eight percent of patients indicated that they were very satisfied or satisfied with the POC INR system. The authors conclude that nurse-managed POC INR testing is quick, convenient, less painful, and more satisfying for patients compared with traditional venipuncture and telephone follow-up.

Anticoagulants↗

A randomized trial of three diabetes registry implementation strategies in a community internal medicine practice.

BACKGROUND: Disease registries are powerful tools with the potential to transform the way chronic diseases are managed. To date, however, little work has been done to determine how to optimize the implementation of a chronic disease registry in practice. METHODS: Twenty-nine physicians and their nurse teams in a large community internal medicine practice participated in this 6-month prospective randomized trial in 2000. Teams were assigned to one of three implementation strategies using information from a diabetes registry. Process and outcome measures for diabetes management were analyzed. Process measures included the percentage of patients completing glycosylated hemoglobin (Hgb) testing within 6 months and low-density lipoprotein (LDL) testing within 12 months. Outcome measures included the percentage of patients with a glycosylated Hgb > 9.3% (equivalent to a HgbA1c > 8.0%), the percentage of patients with an LDL cholesterol > 130 mg/dl, and the percentage of patients with controlled blood pressure, defined as < 130/85 millimeters of mercury. Mean change in LDL and glycosylated Hgb values was also measured. RESULTS: Teams randomized to an intervention strategy that included direct letters to patients showed significant improvement across a number of measures. The improvement was most apparent among patients without recent testing or with poorly controlled disease. The two interventions that did not include direct patient letters resulted in limited improvement. DISCUSSION: Disease registries can be used to improve outcomes in the management of diabetes and other chronic diseases. Better outcomes were seen in patients who received letters based on registry-generated data. This strategy should be included as part of a comprehensive chronic disease management plan. Further refinements in the use of registries should result in further incremental improvement.

Aged↗