Test your knowledge of fluid and electrolyte management--Part 2.
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Humans↗
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Results for “Knowledge Management”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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High-frequency oscillatory ventilation in adults: respiratory therapy issues.
OBJECTIVE: To summarize clinical information and assessment techniques relevant to respiratory therapists caring for adult patients on high-frequency oscillatory ventilation (HFOV). DATA SOURCE: Review of observational studies, controlled trials, case reports, institutional experience, and hospital HFOV guidelines for adult patients. DATA SUMMARY: Respiratory therapists require unique physical assessment skills and knowledge in managing patients on HFOV. Respiratory therapy procedures relevant to HFOV include setting endotracheal tube cuff leaks, performing lung recruiting maneuvers, endotracheal suctioning, and monitoring ventilator parameters. Respiratory therapists serve as essential team members in the creation and implementation of written HFOV guidelines (e.g., algorithms) to optimize patient care. CONCLUSION: Respiratory therapy assessment and procedural skills are essential in providing optimal care to adult patients on HFOV.
High-Frequency Ventilation↗
Acute renal failure in pregnancy.
OBJECTIVES: To provide an evidence-based, up-to-date review of the literature regarding the assessment and management of acute renal failure that may affect women during pregnancy and the postpartum period. DESIGN: A review of the current literature was performed. RESULTS: Acute renal failure is a rare complication of pregnancy but is associated with significant morbidity and mortality. Management requires knowledge of the renal physiologic changes occurring in pregnancy and the relevant diagnoses, both pregnancy-specific and those that may coincidentally occur with pregnancy. In addition, fetal effects must be taken into consideration. CONCLUSIONS: Ideal care for women with acute renal failure in pregnancy or postpartum requires a multidisciplinary approach that may include maternal-fetal medicine, critical care medicine, nephrology, and neonatology specialists.
Acid-Base Equilibrium↗
Treatment of hip dislocation in Kabuki syndrome: a report of three hips in two patients.
The incidence of hip dislocation in Kabuki syndrome (KS) is thought to be between 18% and 40%. Although hip dislocation is apparently well recognized in KS, to our knowledge, its management and outcome have not previously been addressed in the literature. We report 2 children (3 hips) with KS and hip dislocation who underwent surgical treatment with a minimum of 24-month follow-up. In addition, we review the current literature on the treatment of orthopaedic problems in KS.
Abnormalities, Multiple↗
Integrating knowledge workers and the organization: the role of IT.
Agency theory is primarily concerned with the relationship between the principal (employer/purchaser) and the agent (employee/contractor) in the issue of goal-aligned behavior. Jensen and Meckling and others were not referring to a knowledge worker agent in their conceptualization of the principal/agent relationship. The significance of having a knowledge worker agent is that the decision rights are no longer located with the principal but with the agent. This in turn has a tremendous bearing on goal alignment and agency problems. We propose that information systems/information technology (IS/IT), in particular enterprise wide systems, can alleviate these agency problems. We illustrate this through a case example from health care, an industry with a high proportion of knowledge worker agents.
Contract Services↗
Foucault on targets.
This paper seeks to gain an insight into the behavior of a large NHS trust, in its attempt to meet a 90 percent patient access target, in a week long national audit in March 2003. Why did individuals act in dramatically different ways to their norm over this period. The work of Michel Foucault is used to explore these issues. The discourses of power, knowledge, discipline and governmentality are identified as key foucaudian themes that offer an alternative interpretation of how individuals behave in their place of work. The importance of the historical context of discourse within the NHS cannot be underestimated in shaping the behavior of individuals and groups today. Power and knowledge permeate NHS organizations through disciplinary practices and dressage. Governmentality seeks to maintain the status quo through disciplinary processes such as national healthcare targets. The natural response of NHS organizations is therefore, to seek order and conformity rather than disorder and conflict.
Cooperative Behavior↗
Risk factors for an untoward medication event among elders in community-based nursing caseloads in Australia.
This study sought to develop and test a set of criteria to distinguish elders at high risk of an untoward medication event within community nursing caseloads. A descriptive correlational design was used to identify relevant risk factors for elders. Data on medication knowledge, regime, management abilities, and adherence were obtained from 111 elders receiving community nursing care. Four predictors--12 or more doses of medications per day, more than one prescriber, caregiver available, and sometimes forgetting to take medications--of complexity (R2 explaining 39% of the variance) and adherence (R2 explaining 49% of the variance) were identified as potential factors that subsequently confirmed a discrete group of high risk elders. The use of these four risk factors or screening criteria is recommended for older people within community nursing caseloads.
Aged↗
Teaching airway management is dependent on the knowledge of the teachers.
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Anesthesia↗
Education in childhood asthma: a preliminary study of need and efficacy.
This study initially assessed in parents of children with asthma, their knowledge of the condition and its management. Using a knowledge questionnaire a mean score for 30 parents of 69.1% was found, with a range between 44% and 86%. The study went on to examine whether an educational intervention program for parents could both improve knowledge and lower morbidity. The results for 14 parents who completed the educational intervention program were compared to those for 14 parents who did not complete the program. Both groups showed an increase in knowledge at 1 and 3 months after their initial interview (P less than 0.005) but the active group had significantly better knowledge at 1 month (P less than 0.0001) and 3 months (P less than 0.001) compared to the control group. There was no change in morbidity in either group as assessed by hospital admissions, visits to a doctor, days off school and number of wheezing episodes. We have shown that knowledge can be improved by an educational program for parents of children with asthma but have not been able to demonstrate an effect on short-term morbidity.
Asthma↗
Family involvement and metabolic control of childhood diabetes.
To investigate the association between the family environment and metabolic control of childhood diabetes 20 diabetic children aged between 4 and 12 years with same-sex healthy siblings and two cohabiting parents were selected. The parents were interviewed separately and completed questionnaires about their own and their spouse's involvement and shared activities with both children, diabetic management, and knowledge of and attitudes towards diabetes. They also completed the Moos Family Environment Scale (FES) which yields ten sub-scales relating to different aspects of family functioning as did 20 sets of parents with age- and sex-matched healthy children, who also completed questionnaires concerning their involvement and shared activities with their children. There were no differences between the families of diabetics and of controls in the extent to which either parent was involved with their children or in the attention each child received. Fathers of diabetic children differed from controls in their use of punishment and diabetic families were less achievement oriented. The degree of metabolic control (HbA1 assessment at three-monthly intervals) was related to parental involvement with the non-diabetic child and to some aspects of the FES including parental incongruence. These differences in family functioning suggest useful directions for possible intervention programmes.
Attitude to Health↗
Cultural and religious influences in diabetes care in Great Britain.
Type 2 diabetes is four times more common in people originating from the Indian subcontinent (Asians) than in white English Caucasians. British Asians with diabetes have been shown to have poorer blood glucose control, awareness of diabetes management, and knowledge of complications. This review examines some of the dietary customs that can affect glucose control, problems with communication and diabetic education, and a brief description of health beliefs commonly held by Asian patients that may help the physician understand why some patients appear to show poor compliance with accepted Western medicine. Patients must always be approached as individuals with their own unique needs within the context of their cultural backgrounds.
Asia↗
Developing integrated knowledge services for NHS Scotland: managing continuity and transition within a new collaborative dynamic.
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Cooperative Behavior↗
Clinical nutrition of exotic pets.
Successful nutritional management requires knowledge of the natural history of exotic pets, nutrient contents of foods, and roles of water, calories, and nutrients in optimal health. Unestablished dietary requirements, lack of balanced commercial diets and mismanagement by owners cause nutritional problems that affect health and recovery from illness and trauma. When presented with a sick exotic pet, veterinarians should check for provision of appropriate wholesome water and food in optimal amounts. Malnutrition and dehydration are common in exotic pets and often result from mismanagement. Starvation is common in carnivores eating whole vertebrate prey, whereas specific nutrient deficiencies are more common in herbivores and insectivores. The more common nutritional deficiencies are calcium and vitamin D3, vitamin A, thiamin, and vitamin E. When treating sick exotic pets, nutrition and fluid support may be critical to recovery.
Animal Nutritional Physiological Phenomena↗
How do patients with HIV perceive their general practitioners?
OBJECTIVE: To study the perceptions of patients with HIV of their general practitioners in terms of knowledge, abilities, confidence, and satisfaction. DESIGN: Questionnaire survey of inpatients, outpatients, and members of a self help group. SETTING: Two city hospitals, three outpatient clinics, and one AIDS self help group in Munich and Berlin, Germany. SUBJECTS: All 402 patients available between 1 September 1988 and 31 May 1989. MAIN OUTCOME MEASURES: General practitioners' attitudes towards the patients' HIV status; patients' experience of treatment rejection; reception in the general practitioner's office; the doctor's perceived knowledge about HIV and AIDS. RESULTS: 394 of 402 patients consented to interview; 87% were registered with a general practitioner and 91% of those indicated that the doctor was aware of their HIV diagnosis. The overwhelming majority of patients (94%) had a friendly or at least neutral reception in the general practitioner's surgery and only six patients' general practitioner changed his or her behaviour for the worse because of the HIV diagnosis. Two thirds of patients said they would consult first with their primary care doctor for a physical problem, but only 13% would do so for psychological problems. Over a third of the patients did not routinely inform other doctors or medical staff about their HIV status, but there was no significant correlation between this concealment and ever having been rejected by a doctor (7%) or a dentist (12%). CONCLUSION: Most patients expressed a high degree of satisfaction with their general practitioners in terms of confidential issues, attitudes, knowledge, and management.
Attitude of Health Personnel↗
Radiographic and CT findings in complications following pulmonary resection.
A variety of pulmonary resection techniques are currently available, including pneumonectomy (intrapleural, extrapleural, intrapericardial, and sleeve pneumonectomy), lobectomy, and limited resection (sleeve lobectomy, segmentectomy, nonanatomic parenchyma-sparing resection). However, pulmonary resection is often followed by postoperative complications that differ according to the type of surgery and the time elapsed since surgery was performed. The most common complications are bleeding, pulmonary edema, atelectasis, pneumonia, persistent air leak, bronchopleural fistula, and empyema. Other, less frequent complications include cardiac herniation, lung torsion, chylothorax, anastomotic dehiscence, wound infection, esophagopleural fistula, and recurrent tumor. The radiologist plays a major role in the diagnosis of various complications following pulmonary resection. Unfortunately, chest radiography has a relatively low diagnostic accuracy in the detection of these complications. When radiographic findings are subtle or equivocal, computed tomography frequently allows more accurate identification of the disease process. Several complications that follow pulmonary resection are life-threatening and require prompt management. Therefore, knowledge of the diverse radiologic appearances of these complications as well as familiarity with the clinical settings in which specific complications are likely to occur are vital for prompt, effective treatment.
Bronchial Fistula↗
Superwarfarin (brodifacoum) poisoning.
A case of self-ingestion of brodifacoum that resulted in spontaneous intra-abdominal haemorrhage, circulatory shock, rhabdomyolysis and acute renal failure is reported. Current knowledge and management of superwarfarin poisoning are discussed.
4-Hydroxycoumarins↗
The numerical modelling and process simulation for the fault diagnosis of rotary kiln incinerator.
The numerical modelling and process simulation for the fault diagnosis of rotary kiln incinerator were accomplished. In the numerical modelling, two models applied to the modelling within the kiln are the combustion chamber model including the mass and energy balance equations for two combustion chambers and 3D thermal model. The combustion chamber model predicts temperature within the kiln, flue gas composition, flux and heat of combustion. Using the combustion chamber model and 3D thermal model, the production-rules for the process simulation can be obtained through interrelation analysis between control and operation variables. The process simulation of the kiln is operated with the production-rules for automatic operation. The process simulation aims to provide fundamental solutions to the problems in incineration process by introducing an online expert control system to provide an integrity in process control and management. Knowledge-based expert control systems use symbolic logic and heuristic rules to find solutions for various types of problems. It was implemented to be a hybrid intelligent expert control system by mutually connecting with the process control systems which has the capability of process diagnosis, analysis and control.
Equipment Failure↗
Nursing leadership in Chile: a concept in transition.
The purposes of this two-year research study were to uncover Chilean nurses' perspectives of the elements that comprise leadership, and to identify challenges faced by nurse leaders in modern health administration. The research question is, What are the structural components that define and characterize nursing leadership in Chile? Nine nurses from different professional backgrounds volunteered to take part in audiorecorded successive interviews. The research methodology was a kind of grounded theory. Findings suggest that leadership is characterized mainly by exerting a positive influence on others based on good communication, knowledge of management, and a futurist vision of the nursing profession. Crisis and transition in nursing leadership were associated with external and internal forces, such as reforms in healthcare organizations and changes in the nursing conceptual framework.
Chile↗