oalib

Publish in OALib Journal

ISSN: 2333-9721

APC: Only $99

Submit

Search Results: 1 - 6 of 6 matches for " Luedy "
All listed articles are free for downloading (OA Articles)
Page 1 /6
Display every page Item
October 2012 critical care case of the month
Luedy H,Singarajah CU
Southwest Journal of Pulmonary and Critical Care , 2012,
Abstract: No abstract available. Article truncated at 150 words. History of Present Illness An 85 year old patient was admitted with hypotension and respiratory failure. He was intubated shortly after arrival and mechanical ventilation was begun. Fluids and vasopressors were begun for his hypotension. PMH, SH, FH His past medical history included peripheral vascular disease, abdominal aortic aneurysm repair, type 2 diabetes mellitus, hypertension, alcohol use, coronary artery disease, chronic obstructive pulmonary disease and hyperlipidemia. Physical Examination His vital signs were a temperature of 98.6 degrees F, heart rate 110 beats/min, respiratory rate 14 breaths per minute while intubated and receiving mechanical ventilation, and BP of 95/65 mmHg on vasopressors. He was sedated. Lungs were clear and the heart had a regular rhythm without murmur or gallop. Abdominal examination was unremarkable and neurologic exam was limited because of sedation but without localizing signs. Plantar reflexes were down-going. Admission Laboratory Significant initial laboratory findings included a white blood cell count …
Impact of Metabolic-Syndrome Risk Factors on the Absenteeism of Health Workers from a Brazilian University Hospital  [PDF]
Almerinda Luedy, Danile Leal Barreto, Hugo Costa-Ribeiro Júnior
Health (Health) , 2018, DOI: 10.4236/health.2018.106064
Abstract: Objective: Analyzing the association between Metabolic Syndrome (MS) risk factors and work absenteeism due to illnesses among University Hospital employees in Salvador City, Bahia, Brazil. Methods: Cross-sectional study comprised 1173 Bahia Federal University Hospital employees: 57.3% of them were federal employees (statutory officers) and 42.7% were civil servants (CLT employees). Participants were in the age group 41.5 years: 69.4% were female and 30.6% were male. Results: MS prevalence in employees reached 6.6%; women accounted for 69.7% of the total. The percentage increases with age and has similar proportion among directcare providers and ancillary supports personnel, 40.8% and 39.5%, respectively. The risk factor analysis showed 25% hypertension, 54.6% weight excess (18.4% obese and 36.2% overweight patients), 20% hypercholesterolemia, 9.9% hypertriglyceridemia and 6.5% diabetes mellitus prevalence. Absenteeism longer than one day within the studied population reached 40.1%. Osteoarticular diseases were the most common reason for absenteeism, accounting for 50.7% of it: 62.6% of whom were either overweight or obese. The mean cost with absenteeism per employee was R$5492.87 ($2347.00 US Dollars), and it corresponds to annual cost of R 2,587,139.53 ($1,105,610.00 US Dollars). The highest cost with absenteeism caused by illnesses was recorded for female workers; for federal employees who were patient caregivers, who worked in the Pediatric Centre and who worked at night shifts. Conclusion: The high Metabolic Syndrome risk factors and overweight incidence are responsible for the increased costs faced by hospitals due to high absenteeism rates.
February 2013 critical care case of the month: thoracentesis through the looking glass
Singarajah CU,Blum JE,Thomas AR,Luedy H
Southwest Journal of Pulmonary and Critical Care , 2013,
Abstract: No abstract available. Article truncated at 150 words. A 62 year old male was recently diagnosed with Stage 4 squamous cell left lung cancer with metastases to the pleura, brain and mediastinum. He also had known chronic obstructive pulmonary disease (COPD) with a FEV1 = 1.96 L and a known left side pleural effusion (see Figure 1). Figure 1. Baseline chest radiograph showing left pleural effusion (red arrow). He was seen as an outpatient for symptomatic shortness of breath and underwent real time ultrasound guided left sided thoracentesis removing 500 ml of straw-colored fluid. The procedure was uneventful except that near the end, the patient started to cough. He denied any symptoms post procedure apart from some minor puncture site pain. A routine post procedure chest x-ray was performed (Figure 2). Figure 2. Post-thoracentesis x-ray (Panel A) and its negative image (Panel B). What new abnormality is identified on the post-procedure chest x-ray?1.Left pneumothorax2.Right pneumothorax …
Correlation of compliance with central line associated blood stream infection guidelines and outcomes: a review of the evidence
Hurley J,Garciaorr R,Luedy H,Jivcu C
Southwest Journal of Pulmonary and Critical Care , 2012,
Abstract: Background Clinical practice guidelines are developed to assist in patient care but the evidence basis for many guidelines has been called into question. Methods We conducted a literature review using PubMed and analyzed the overall quality of evidence and made strength of recommendation behind 8 Institute of Health Care (IHI) guidelines for prevention of central line associated blood stream infection (CLABSI). Quality of evidence was assessed by the American Thoracic Society (ATS) levels of evidence (levels I through III). We also examined data from our intensive care units (ICUs) for evidence of a correlation between guideline compliance and the development of VAP.Results None of the guidelines was graded at level I. Two of the guidelines were graded at level II and the remaining 6 at level III. Despite the lack of evidence, 2 of the guidelines (hand hygiene, sterile gloves) were given a strong recommendation. Chlorhexidine and use of nonfemoral sites were given a moderate recommendation. In our ICUs compliance with the use of chlorhexidine correlated with a reduction in CLABSI (p<0.02) but the remainder did not.Conclusions The IHI CLABSI guidelines are based on level II or III evidence. Data from our ICUs supported the use of chlorhexidine in reducing CLABSI. Until more data from well-designed controlled clinical trials become available, physicians should remain cautious when using current IHI guidelines to direct patient care decisions or as an assessment of the quality of care.
Gest?o pública por resultados: contrato de gest?o como indutor de melhorias em um hospital universitário
Luedy, Almerinda;Mendes, Vera Lúcia Peixoto S.;Ribeiro Júnior, Hugo;
Organiza??es & Sociedade , 2012, DOI: 10.1590/S1984-92302012000400005
Abstract: this paper examines the extent to which management contracts have achieved results in improving the performance of a university hospital. this is based on the assumption that success in contracting depends on changes in the organizational structure, in the production process and relations between agents to reduce the fragmentary character of public policy. the debate about cycles of management change was reviewed in the light of the new managerialism approach "theory of fragmentation" of public policy. document analysis and semi-structured interviews were used, and the data was interpreted by analyzing categorical content. the strategies and organizational changes resulting from contracting yielded results for the management model, increased hospital performance, defined control criteria and evaluation, changed the organizational structure, enabling a more decentralized and participatory management. we conclude that the changes resulting from management contracts positively impacted performance indicators, increasing efficiency and effectiveness and that it is possible to integrate health policy and education, avoiding the fragmentation of public policies.
Gest o pública por resultados: contrato de gest o como indutor de melhorias em um hospital universitário
Almerinda Luedy,Vera Lúcia Peixoto S. Mendes,Hugo Ribeiro Júnior
Organiza??es & Sociedade , 2012,
Abstract: Resumo ----- Este trabalho analisa em que medida o contrato de gest o vem alcan ando resultados na melhoria do desempenho de um Hospital Universitário (HU). Parte-se do pressuposto de que o sucesso da contratualiza o depende de mudan as na estrutura organizacional, no processo de produ o e nas rela es entre os agentes, para reduzir o caráter fragmentário das Políticas Públicas. Foi revisado o debate sobre os ciclos de mudan as gerenciais, à luz da abordagem do Novo Gerencialismo da “Teoria da Fragmenta o” das políticas públicas, e realizado estudo de caso de natureza qualitativa, exploratória e analítica, em um HU que possui contrato de gest o. Utilizam-se a análise documental e entrevistas semiestruturadas, sendo os dados interpretados mediante análise categorial de conteúdo. As estratégias e mudan as organizacionais decorrentes da contratualiza o produziram resultados referentes ao modelo de gest o, como o aumento do desempenho hospitalar, defi ne critérios de controle e avalia o, e mudan a na estrutura organizacional, possibilitando uma gest o mais descentralizada e participativa. Conclui-se que as mudan as decorrentes do contrato de gest o impactaram positivamente nos indicadores de desempenho, elevando a efi ciência e efetividade e mostrando que é possível integrar as Políticas de Saúde e Educa o, evitando-se a fragmenta o das Políticas Públicas. ----- Managing for Results: management contract as inducer of improvements in an University Hospital ----- Abstract ----- This paper examines the extent to which management contracts have achieved results in improving the performance of a University Hospital. This is based on the assumption that success in contracting depends on changes in the organizational structure, in the production process and relations between agents to reduce the fragmentary character of Public Policy. The debate about cycles of management change was reviewed in the light of the New Managerialism approach "Theory of fragmentation" of Public Policy. Document analysis and semi-structured interviews were used, and the data was interpreted by analyzing categorical content. The strategies and organizational changes resulting from contracting yielded results for the management model, increased hospital performance, de ned control criteria and evaluation, changed the organizational structure, enabling a more decentralized and participatory management. We conclude that the changes resulting from management contracts positively impacted performance indicators, increasing ef ciency and effectiveness and that it is possible to integr
Page 1 /6
Display every page Item


Home
Copyright © 2008-2017 Open Access Library. All rights reserved.