排序方式: 共有79条查询结果,搜索用时 562 毫秒
21.
Avoidable patient harm is a major public health concern, and may already have surpassed heart disease as the leading cause of death in the United States. While the public health community has contributed much to one aspect of patient harm prevention, infection control, the tools and techniques of public health have far more to offer to the emerging field of patient safety science. Patient safety practice has become increasingly professionalized in recent years, but specialist degree programs in the field remain scarce. Healthcare organizations should consider graduate training in public health as an avenue for investing in the professional development of patient safety practitioners, and schools and programs of public health should support further research and teaching to support patient safety improvement. 相似文献
22.
Windy Olaya MD Jasmine Wong MD Jan Wong MD John Morgan DrPH CPH Kevork Kazanjian MD Sharon Lum MD 《Annals of surgical oncology》2013,20(2):627-632
Purpose
We sought to compare the number of lymph nodes (LN) resected in axillary lymph node dissections (ALND) and sentinel lymph node dissections (SLND), and to assess the validity of registry reporting for axillary staging in breast cancer.Methods
Women in the California Cancer Registry who underwent surgical axillary staging for T1/T2, M0 breast cancer between 2004 and 2008 were evaluated. The number of LN resected in patients reported as having SLND+ALND and ALND were assessed for compliance with 6 and 10 LN threshold definitions for ALND. The proportion of patients with ≤3 LN removed was assessed for patients receiving SLND only.Results
Of 71,907 patients, 45.5 % had SLND, 24.0 %, SLND+ALND, and 30.5 %, ALND. The median number of LN resected with SLND cases was 2 (range 1–41); SLND+ALND, 9 (range 1–63); and ALND, 11 (range 1–81) (p < 0.0001). Of patients undergoing ALND, 56.7 % had ≥10 LN removed; 46.2 % of patients with SLND+ALND had ≥10 LN removed (p < 0.0001). Overall, 75.5 % of patients with ALND had ≥6 LN removed and 67.8 % of patients with SLND+ALND had ≥6 LN removed (p < 0.0001). Of those receiving only SLND, 83.4 % had ≤3 LN removed.Conclusions
A significant proportion of patients did not meet the minimum LN count thresholds for full ALND or had excess LN removed in a SLND. Further investigation is required to determine whether absolute LN number or reported operative procedure and implied surgical technique better defines axillary staging in a registry database. 相似文献23.
Dr. David P. Winchester MD Herman R. Menck CPH Robert T. Osteen MD William Kraybill MD 《Annals of surgical oncology》1995,2(3):207-213
Background: As a result of clinical trial publications, breast conservation treatment has been increasingly used for invasive breast
cancer. The patterns of care for ductal carcinoma in situ (DCIS) were analyzed for the years 1985, 1986, 1988, 1990, and 1991
to determine whether the same treatment principles had been applied to patients with noninvasive disease.
Methods: Data submitted on 20,556 patients with DCIS during the 5 study years were analyzed with regard to basic demographics and
treatment trends.
Results: Breast-conserving surgery for DCIS increased from 20.9% in 1985 to 35.4% in 1991. Modified radical mastectomy remained constant
at 42%. Axillary node surgery increased from 52% in 1985 to 58.5% in 1991. The use of radiation therapy for patients with
partial mastectomy and no lymph node dissection ranges from 24.2% in 1990 to 37.7% in 1985, with 31.1% receiving radiation
therapy in 1991. Patients undergoing lymph node dissection with partial mastectomy were more than twice as likely to receive
postoperative radiation therapy than were patients without lymph node dissection.
Conclusions: Modified radical mastectomy remains the most common surgical procedure, despite the eligibility of many women for breast
conservation treatment. As of 1991 the majority of women were still undergoing axillary lymph node surgery despite a node
positivity rate of ≈1%. Radiation therapy is significantly underused in patients with partial mastectomy, especially when
no nodes were removed. Clinical trial results and professional education for DCIS treatment should change these trends.
Presented at the 47th Annual Cancer Symposium of The Society of Surgical Oncology, Houston, Texas, March 17–19, 1994. 相似文献
24.
25.
26.
The Role of School Design in Shaping Healthy Eating‐Related Attitudes,Practices, and Behaviors Among School Staff 下载免费PDF全文
27.
A new frontier in healthcare risk management: Working to reduce avoidable patient suffering 下载免费PDF全文
This article presents a new avenue for healthcare risk managers to drive improvement for patients and healthcare organizations alike: working to reduce avoidable patient suffering. It briefly describes the problem of patient suffering, differentiates between avoidable and unavoidable suffering, and suggests that common risk management tools can be used to tackle the problem. It also highlights a success story from one large health system. 相似文献
28.
29.
30.
A Statewide Profile of Frequent Users of School‐Based Health Centers: Implications for Adolescent Health Care 下载免费PDF全文