排序方式: 共有18条查询结果,搜索用时 15 毫秒
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PH Manso F Carmona ADN Jácomo H Bettiol MA Barbieri APCP Carlotti 《Acta paediatrica (Oslo, Norway : 1992)》2010,99(9):1356-1360
Aim: To evaluate whether the ventricular septal defect (VSD) size, along with the degree of preoperative growth impairment and age at repair, may influence postoperative growth, and if VSD size can be useful to identify children at risk for preoperative failure to thrive. Methods: Sixty‐eight children submitted to VSD repair in a Brazilian tertiary‐care institution were evaluated. Weight and height measurements were converted to Z‐scores. Ventricular septal defect size was normalized by dividing it by the aortic root diameter (VSD/Ao ratio). Results: Twenty‐six patients (38%) had significantly low weight‐for‐height, 10 patients (15%) had significantly low height‐for‐age and 13 patients (19%) had both conditions at repair. Catch‐up growth occurred in 82% of patients for weight‐for‐age, in 75% of patients for height‐for‐age and in 89% of patients for weight‐for‐height. Weight‐for‐height Z‐scores at surgery were significantly lower in patients who underwent repair before 9 months of age. The VSD/Ao ratio did not associate with any other data. On multivariate analysis, weight‐for‐age Z‐scores and age at surgery were independent predictors of long‐term weight and height respectively. Conclusion: The VSD/Ao ratio was not a good predictor of preoperative failure to thrive. Most patients had preoperative growth impairment and presented catch‐up growth after repair. Preoperative growth status and age at surgery influenced long‐term growth. 相似文献
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Meeting the Challenge of Managed Care Through Clinical Pathways for Bariatric Surgery 总被引:1,自引:0,他引:1
Amanda D Rouse RN MSN Bobbie Lou Tripp RN BSN Sharon Shipley RN ADN Walter Pories MD Paul Cunningham MD Kenneth MacDonald Jr. MD 《Obesity surgery》1998,8(5):530-534
Background: The 1990s will bring sweeping changes in managed care and capitation. Health care providers are continually searching
for new ways to improve the quality of patient-care outcomes in the obese. Improving clinical care by promoting the use of
processes that have been proved to yield optimal outcomes has become a powerful strategy for measuring the value of services
provided. Methods: To address this cost/quality paradox, an optimal care path (OCP) was developed as a guideline for all patients
undergoing gastric bypass or laparoscopic adjustable gastric banding. A transdisciplinary team developed the OCP, preprinted
orders, discharge home instruction sheet, and daily guidelines for patients. All patients were provided with OCPs from July
1995 to September 1997. Results: Length of stay decreased from 6.5 days to 5.4 days (16.9%); the average total charges decreased
17.6%, or $2,683; the percentage of wound infections decreased; and communication between, and collaboration of, interdisciplinary
team members increased across the continuum of care. Conclusions: The study suggests that the use of OCP does not impair quality
of care and can produce significant cost savings to a health care facility. 相似文献
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Colleen Kennedy RN ADN staff nurses Sarah Angermuller RN MEd MSN staff nurse instructor in the nursing program Robin King RN BSN instructor in the nursing program Sheri Noviello RN MSN staff nurse instructor in the nursing program Joann Walker RN ADN staff nurses Joanie Warden RN MSN staff nurse instructor in the nursing program Susan Vang RN MSN staff nurse instructor in the nursing program 《Journal of emergency nursing》1996,22(6):566-569
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