Nurs Econ
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Comparative Study
Comparative effectiveness of standard endotracheal tubes vs. endotracheal tubes with continuous subglottic suctioning on ventilator-associated pneumonia rates.
Ventilator-associated pneumonia (VAP) accounts for the majority of nosocomial pneumonias, which may increase intensive care and prolonged hospital stays. Endotracheal tubes allowing continuous subglottic suctioning may reduce VAP; however, they are more expensive than standard endotracheal tubes not allowing continuous suctioning. he objective of this study was to measure the comparative costs associated with continuous subglottic suctioning endotracheal tubes (CSS-ETT) versus standard endotracheal tubes (S-ETT) among intubated patients and whether cost differential is offset by the occurrence of VAP in patients receiving either type of intubation. ⋯ The mean total hospital charges were higher for the S-ETT group ($103,600; CSS-ETT= $88,500) (p = 0.3). Although the average number of intubation days and ICU days were greater for the CSS-ETT group, there were no cases of VAP compared to the S-ETT group. ased upon the one S-ETT VAP case and the VAP attributable costs, it is cost effective to use the CSS-ETT.
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Anesthesiologists and certified registered nurse anesthetists provide high-quality, efficacious anesthesia care to the U. S. population. ⋯ CRNAs are generally salaried, their compensation lags behind anesthesiologists, and they generally receive no overtime pay. As the demand for health care continues to grow, increasing the number of CRNAs, and permitting them to practice in the most efficient delivery models, will be a key to containing costs while maintaining quality care.
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Many hospitals and health care systems are focusing on improving performance and patient outcomes in cardiovascular services, with a particular emphasis on how the management of heart failure can prevent readmissions, decrease the cost per case, and improve the quality and satisfaction for this particular patient population. Quality outcomes and optimal lifestyle management of chronic care diseases, such as heart failure (HF), will be deciding factors in patient choice about health care providers and systems. ⋯ Given the significant volumes of HF readmissions, as well as numerous potential policy changes focused on reducing costs, properly aligning incentives, and improving quality, HF may be an ideal place to start to begin initiatives around readmission reduction. For an organization to identify and execute appropriate strategies, a structured approach to assessment and implementation can ensure the highest likelihood of success.
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Comparative Study
Shift work in nursing: is it really a risk factor for nurses' health and patients' safety?
There is evidence in the scientific literature of the adverse physiological and psychological effects of shift work, including disruption to biological rhythm, sleep disorders, health problems, diminished performance at work, job dissatisfaction, and social isolation. In this study, the results of health problems and sleep disorders between female and male nurses, between daytime and shift nurses, and between sleep-adjusted and non-sleep-adjusted shift nurses were compared. Also the relationship between adjustment to shift work and organizational outcomes (errors and incidents and absenteeism from work) was analyzed. ⋯ This research adds two additional findings to the field of shift work studies. The first finding is that female shift workers complain significantly more about sleep disorders than male shift workers. Second, although high rates of nurses whose sleep was not adapted to shift work were found, this did not have a more adverse impact on their health, absenteeism rates, or performance (reported errors and incidents), compared to their "adaptive" and "daytime" colleagues.