Family medicine
-
The purpose of this analysis is to determine the effect of the Acute Physiology and Chronic Health Evaluation (APACHE) II score and other clinical variables on survival following cardiopulmonary resuscitation (CPR) and to identify patient subpopulations with extremely poor survival. ⋯ The APACHE II score is a useful predictor of failure to survive to discharge following CPR. Several groups of patients were identified with negligible rates of survival to discharge. Physicians should use such prediagnostic information to provide patients with informed consent when discussing do-not-resuscitate (DNR) orders. We suggest that physicians make a special effort to address the DNR status of patients falling to one of the negligible-survival groups identified by this study.
-
Duplicate prescription pads are used in many family practice residency programs to monitor prescribing patterns and detect errors in the actual prescription-writing process. This study looked at whether the review of duplicate prescriptions could be enhanced by adding the patient's diagnosis to the prescription. ⋯ The addition of the patient's diagnosis to the prescription enhanced the review of duplicate prescriptions. It permitted the evaluation of not only the prescription-writing process but also the decision-making process that led to writing the prescription. It also permitted a more thorough evaluation of appropriate drug use.
-
Medical students and residents are more likely to understand the health needs of a community if they have community-based practical experience during their training. This report describes a community-oriented educational experience for medical students and family practice residents in rural North Carolina. ⋯ A community-oriented primary care rotation can provide students and residents with an important understanding of the health system and health problems of a community.