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Biomedical subjects

V B Navarro

Publications and source records attributed to V B Navarro.

8 recordsLinked to original sources
PubMed1995

Allocation of nursing care hours in a combined ophthalmic nursing unit.

Traditional service configuration with separate nursing units for outpatient and inpatient care is becoming ineffective for new patient care delivery models. With the new configuration of a combined nursing unit, it was necessary to rethink traditional reporting methodologies and calculation of hours of care. This project management plan is an initial attempt to develop a standard costing/productivity model for a combined unit. The methodology developed from this plan measures nursing care hours for each patient population to determine the number of full time equivalents (FTEs) for a combined unit and allocates FTEs based on inpatient (IP), outpatient (OP), and emergency room (ER) volumes.

Cost-Benefit Analysis↗
PubMed1993

Alternative patient care delivery systems: a combined ophthalmic nursing unit and a cost effective ophthalmic surgery program.

To be competitive as a tertiary facility in today's healthcare environment, our institute implemented two nursing programs using the Continuous Quality Improvement (CQI) framework: a) creation of the Nursing and Trauma Center, a nursing unit with the flexibility to adjust to continuing changes in patient mix comprising three nursing units (eye emergency room, same day surgery unit, and inpatient unit) designed to consolidate and standardize care to ophthalmic patients and develop a multi-skilled nursing staff to provide nursing care to all ophthalmic patient populations; and b) creation of the Controlled Medical Intensity (CMI) program, in which certain ophthalmic surgeries are performed in the most cost effective and efficient manner (while maintaining quality care). Conceived to compete with surgi-centers, CMI surgery is performed under local retrobulbar anesthesia with minimal, one-time intravenous (IV) conscious sedation (administered by operating room/recovery room nurses according to a standard protocol). Surgical supplies are standardized. These expanded roles have given nurses the opportunity to practice professional autonomy using nursing judgment.

Ambulatory Surgical Procedures↗
PubMed1992

Utilizing the nursing process in the ophthalmic operating room documentation.

Nursing documentation has always been regarded not only as time consuming but a nursing activity that is problematic when it comes to compliance. Somehow nurses must find the balance between documentation of significant events and observations versus duplication or repetition of routine patient activities. This paper describes how these problems were met by one institution.

Humans↗
PubMedDate not supplied

First do no harm: routine use of aminoglycosides in the operating room.

For decades aminoglycosides have been used routinely in intraocular surgery to prevent and treat endophthalmitis. However, as more and more studies are conducted, the reality is that these drugs are causing more harm than they are preventing. Summarized herein are the most recent studies concluding that even low-dose aminoglycosides can cause toxic retinal damage. The conclusion, with pertinent recommendations from the Johns Hopkins Hospital, Wilmer Eye Institute Infection Control Committee, is that the questionable benefit of use of aminoglycosides intraoperatively is not justified by the risk of injury.

Amikacin↗
PubMedDate not supplied

Macular translocation--what our patients need to know.

Age-related macular degeneration is the most common cause of rapid and irreversible central vision loss among persons older than 60 years in the United States. Vision loss occurs as a result of choroidal neovascularization in which abnormal blood vessels in the choroid bleed and scar beneath the fovea. If this is caught early, a new approach called macular translocation surgery can be considered. In this procedure, the surgeon moves (translocates) the macula to a healthy area of the retina where it may recover and maintain its function. Moving the fovea allows the surgeon to use laser to destroy the abnormal blood vessels and spare the fovea. As with any procedure, it is important for the patient to have a positive perioperative experience, to be able to report and prevent postoperative complications, arrange follow-up care and transportation, and have realistic expectations of visual outcomes. To this end, a patient education brochure has been developed to ensure a more informed, involved, and satisfied patient. Our topics include: (1) a brief description of macular degeneration, (b) perioperative examinations and procedures, (3) the procedure itself, surgical risks, and postoperative care, (4) appointments for follow-up and laser procedures a few days after surgery, and (5) possible improvements in visual outcomes. Our objectives are to describe macular translocation surgery as it pertains to the management of choroidal neovascularization in age-related macular degeneration and to identify the essential perioperative elements that patients need to know about macular translocation surgery.

Aged↗