Effective clinical practice : ECP
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Angioplasty and stent placement for peripheral arterial occlusive disease has traditionally been performed by radiologists and surgeons. However, cardiologists have recently begun to perform these procedures. It is unknown whether this has affected how often the procedure is done. ⋯ Cardiologists are performing a substantial proportion of peripheral angioplasties. Rates of these procedures are highest in regions where cardiologists do most of the angioplasties.
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We previously found that length of stay in the intensive care unit (ICU) after abdominal aortic surgery increased when fewer ICU nurses were available per patient. We hypothesized that having fewer nurses increases the risk for medical complications. ⋯ Having fewer ICU nurses per patient is associated with increased risk for respiratory-related complications after abdominal aortic surgery.
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Comparative Study
The uneven landscape of newborn intensive care services: variation in the neonatology workforce.
In the past 30 years, the number of neonatologists has increased while total births have remained nearly constant. It is not known how equitably this expanded workforce is distributed. ⋯ The regional supply of neonatologists varies dramatically and cannot be explained by the substitution of neonatal mid-level providers or by the presence of academic medical centers. Further research is warranted to understand whether neonatal intensive care resources are located in accordance with risk and whether more resources improve newborn outcomes.
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Randomized Controlled Trial Clinical Trial
Can evidence change the rate of back surgery? A randomized trial of community-based education.
Timely adoption of clinical practice guidelines is more likely to happen when the guidelines are used in combination with adjuvant educational strategies that address social as well as rational influences. ⋯ We were able to use scientific evidence to engender voluntary change in back pain practice patterns across entire communities.