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At least 19 recordsLinked to original sources
PubMed1976

Polypharmacy in the psychiatric treatment of elderly hospitalized patients: a survey of 12 Veterans Administration Hospitals.

Polypharmacy with psychoactive drugs was surveyed in 1276 elderly psychiatric patients from 12 Veterans Administration hospitals. One out of every six patients received two or more psychoactive agents. No specific combination of drugs was overly popular. The most frequently administered combinations, thioridazine plus phenobarbital and chlorpromazine plus phenobarbital, were administered to only 13 patients each (1% of the sample). The large majority of the combinations involved antipsychotic agents. One antipsychotic drug, thioridazine, was a component of nearly one-third of the combinations. The most frequent pairings were an antipsychotic drug plus and antidepressant, two antipsychotic drugs, and an antipsychotic drug plus an antianxiety agent or sedative-hypnotic. The use of polypharmacy was significantly related to patient age. One out of every four patients 60 to 65 years of age received two or more psychoactive drugs compared to only one out of eight over 75 years of age. The implications of these findings for treatment and research are discussed.

Age Factors↗
PubMedDate not supplied

Experience of transferring an integrated hospital-administration system from a CODASYL data-base to a standard MUMPS file structure.

University College Hospital, a teaching hospital situated in Central London, has been using computers since 1964. Development of an integrated on-line hospital administration computer system was started in 1974. By mid 1977, the components of the system which had been implemented included a patient Master Index, Registration of new patients, Waiting Lists, Bed State, Out-patient Appointments, X-ray, Microbiology and Disease Index. The system was implemented using the Rank Xerox Data Systems (CODASYL based data-base management software, with the majority of applications running on a terminal network supported by transaction processing programs. The experience gained during three years of using such a system is reviewed, with particular emphasis on the ways in which the system matched up in practice to the expected benefits of data-base management facilities. In early 1977, it was decided to replace the Rank Xerox mainframe with a minicomputer which was considered to be a more cost-effective solution to the hospital's computing requirements. The machine selected a PDP 11-70, is running the Digital Equipment Corporation's implementation of Standard MUMPS, an interpretive language developed in a hospital environment, with its own file management software. The decisions which were made in redesigning the existing computer systems for the new machine are discussed. The progress made to date in the transfer of applications from the mainframe to the mini is reviewed, and some of the features of the software available on each machine and its suitability for the implementation of on-line data management and retrieval systems are compared.

Computers↗
PubMed1977

Decision to admit. Criteria for admission and readmission to a Veterans Administration hospital.

Factors related to the decision to hospitalize applicants for psychiatric treatment at a Veterans Administration hospital were explored. For a three-week period, decision makers completed questionnaires following interviews with applicants. It was found that 79% of applicants were "revolving door" patients. These patients were much less likely to be married, and more likely to be homeless and diagnosed as schizophrenic, than patients without previous hospitalizations. A small number of patients were admitted because of characteristics of their illness regardless of their social situations. Patients were not hospitalized on the basis of social or nonpsychiatric criteria alone. A large number were admitted because of a combination of factors, some social in nature and others related to their psychopathology. A social process taking place in the screening interview appeared to have some influence in the decision to admit.

Decision Making↗
PubMed1978

Endemic Serratia marcescens in the Veterans Administration Hospital in Pittsburgh, Pa., 1971--1976.

The incidence of infections due to Serratia marcescens increased steadily at the Veterans Administration Hospital in Pittsburgh, Pennsylvania from 1970 to mid 1975 followed by a decline extending into 1977. One hundred eighty-four Serratia marcescens isolates were collected from 123 patients over a 4-month period in 1975 and were characterized by stereotype and antibiotic sensitivity. Three-fourths of the isolates were clinically significant. Among 24 stereotypes O-:H2 predominated in the urinary tract and O-H12 in respiratory secretions. Clusters of serotypes were on occasion identified in the GU Surgery Ward and the Intensive Care Unit. Uninary isolates showed remarkable resistance to antibiotics; only two thirds were susceptible to amikacin, the most effective agent in vitro. The patients from whom Serratia was isolated were older than the general hospital population (60 vs. 53.6 years of age), were hospitalized longer than the age-corrected controls (62 vs. 34.5 days) and two-thirds of thirds of them acquired the infection in the hospital. Uninary catheterization and prior antibiotic therapy were significant risk factors for urinary infections, and prior surgery contributed to recovery of Serratia from the respiratory tract. Serotype and antibiotype differences between isolates from the urinary and those from the respiratory tract suggest that strains evolved a site specificity.

Anti-Bacterial Agents↗