175 Use of Non-Veteran Administration Medical Emergency Departments by Military Veterans

2011 ◽  
Vol 58 (4) ◽  
pp. S236
Author(s):  
S.M. Schneider ◽  
T. Richardson ◽  
W. Triner ◽  
N.R. Roback ◽  
G. Ellis ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Military Veterans ◽  
Veteran Administration ◽  
Medical Emergency ◽  
Veteran Administration Medical ◽  
Administration Medical

Case Study: A Transactional Analysis Model for a Single Mother and Her Adult Child With Bipolar Disorder

2018 ◽  
Vol 17 (5) ◽  
pp. 296-310
Author(s):  
David J. Carter
Keyword(s):  
Assessment Tool ◽  
Medical Center ◽  
Single Mother ◽  
Veteran Administration ◽  
Personality Factor ◽  
Veteran Administration Medical ◽  
Interaction Patterns ◽  
Transactional Analysis ◽  
Analysis Model

This case study describes a transactional analysis model based on the strain of a single mother with an adult son suffering from bipolar I disorder. The study examines interaction patterns within the clinical setting; the therapeutic view examines contextual factors that affect this mother and her adult son through assessment and recovery with transactional analysis therapy. The 16-session therapeutic experience of a client and his mother is presented. The subjects in the case study were administered the Sixteen Personality Factor Questionnaire (16PF) assessment tool during the second and 16th sessions. There was a significant change from pretest to posttest stens scores regarding increased scores in emotional stability from 2 (extremely low) to 4 (average), rule consciousness from 1 (extremely low) to 3 (moderately low), openness to change from 6 (average) to 8 (moderately high), and self-control from 1 (extremely low) to 4 (average). Decreased scores included apprehension from 9 (extremely high) to 7 (average) and tension from 6 (average) to 3 (moderately low). Behavioral changes after a 1-month follow-up included taking the bus to sign up for a college class, taking his medication as prescribed, getting a part-time job in the kitchen at the Veteran Administration Medical Center, and developing a budget to manage his disability check.

scholarly journals Analysis of Medical Management in Geriatric Patients in the Hospital Emergency Department by Example of Selected Cities with County Status in Poland: A Retrospective Cohort Study

2021 ◽  
Vol 19 (1) ◽  
pp. 48
Author(s):  
Mariusz Celiński ◽  
Mateusz Cybulski ◽  
Joanna Fiłon ◽  
Marta Muszalik ◽  
Mariusz Goniewicz ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Medical Management ◽  
Medical Records ◽  
Emergency Departments ◽  
Geriatric Patients ◽  
Medical Emergency ◽  
Medical Procedure ◽  
Hospital Emergency ◽  
Medical Emergency Teams ◽  
Hospital Emergency Departments

The aim of this study was to analyse medical management in geriatric patients in the Hospital Emergency Departments in the Biała Podlaska County and Chełm County (Poland) between 2016 and 2018 in a group of patients ≥65 years of age. We analysed medical records of 829 patients transported to Hospital Emergency Departments by Medical Emergency Teams. The research was conducted in the period from June 2019 to March 2020. We analysed emergency medical procedure forms and medical records of patients transported to the hospitals. Cardiovascular diseases were diagnosed in 40% of patients. Mortality cases accounted for 3.1% of the 1200 interventions analysed. Ambulance dispatch resulted in the patient being transported to the Hospital Emergency Departments in more than 2/3 of cases. The concordance between the diagnoses made by the Medical Emergency Teams and those made at the Hospital Emergency Departments was confirmed for 78% patients admitted to the department (n = 647), whereas the concordance of classification at the group level was estimated at 71.7% (n = 594). Further in-patient treatment was initiated in some of the patients admitted to the department (n = 385). The mean time of hospital stay was 10.1 days. In conclusion, differences between the initial diagnosis made by the heads of the Medical Emergency Teams and the diagnosis made by the doctor on duty in the Hospital Emergency Departments depended on the chapter of diseases in the ICD-10 classification, but they were acceptable. The majority of the patients were transported to Hospital Emergency Departments. The most common groups of diseases that require Hospital Emergency Departments admission include cardiovascular diseases, injuries due to external causes, and respiratory diseases. A moderate percentage of patients were qualified for further specialist treatment in hospital departments.

Impact of race on survival of prostate cancer patients treated with noncurative intent

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5069-5069 ◽  
Author(s):  
D. Hatcher ◽  
A. E. Rose ◽  
P. J. Christos ◽  
M. Mazumdar ◽  
M. John ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Multivariable Analysis ◽  
Veteran Administration ◽  
Care Facility ◽  
Study Cohort ◽  
Veteran Administration Medical ◽  
Curative Intent ◽  
The Difference

5069 Background: We previously reported that African American (AA) men have a higher recurrence rate than Caucasian (CA) men treated with radical prostatectomy at the New York Veteran Administration Medical Center (NY-VAMC), an equal access to care facility (J Urol. 2006). In the current study, we attempted to examine the differences in survival of AA and CA prostate cancer (PC) patients with clinically detected localized disease treated with non curative intent. We hypothesized that comparing patients whose PC was not altered by primary treatment might give a better idea about the difference, if any, of the natural history of PC in AA compared to CA patients. Methods: Men diagnosed with PC at NY-VAMC during 1990–2005 were identified. Inclusion criteria were: 1) biopsy confirmed PC; 2) no evidence of metastatic disease within 6 months after diagnosis; 3) no curative intent treatment. Results: The study included 530 men (288 AA and 242 CA) with median follow-up of 8.1 years (range: 0.6–17.6 years). AA men presented with significantly higher PSA compared to CA patients (median 18.5 versus 11.4 respectively, p = 0.004), however, there were no differences in age at presentation (median 73 versus 74, p = 0.98) or Gleason score (23% of AA and CA had Gleason >7, p = 0.92). Of the 530 patients, 198 (37%) are alive with disease, 67 (13%) died of prostate cancer, 206 (39%) died of other causes, and 59 (11%) died of unknown causes. AA patients had shorter median overall survival compared to CA patients (8 versus 9 years, respectively), however, the difference was not significant (p = 0.29). Factors most predictive of mortality by Cox regression multivariable analysis were PSA at diagnosis (p = 0.001), Gleason score (p = 0.04), and age of patient at diagnosis (p < 0.0001). Race was not an independent predictor of mortality in this model (p = 0.37). Competing risk analysis distinguishing the types of death is underway. Conclusions: The extended follow up available for our study cohort points to non PC related mortality as the major cause of death in patients treated with non-curative intent. No significant financial relationships to disclose.

scholarly journals Proposing an Optimization Procedure and Applying Management Performance in Health and Medical Emergency on Preparedness of Emergency Department in Suburb City Hospitals

2017 ◽  
Author(s):  
Asma Bahranifard ◽  
Kobra Rahzani ◽  
Ali Akbar Maleki Rad ◽  
Mokhtar Malekpour
Keyword(s):  
Emergency Department ◽  
Emergency Preparedness ◽  
Emergency Departments ◽  
Health Management ◽  
Medical Center ◽  
Optimization Procedure ◽  
World Health ◽  
Medical Emergency ◽  
Hospital Emergency ◽  
Management Performance

Introduction: The management performance of hospitals in emergency departments in coping with clinical hazards is necessary for their success in providing quality services. The purpose of this study is to provide an optimization procedure and applying management performance in health and medical emergency on the rate of emergency preparedness of the suburb city hospitals. Research method: A semi-experimental and interventional descriptive study in the emergency department of Shahid Motahari Hospital in 2015-2016. Data was collected through the standard checklist of hospital emergency responsiveness test to WHO disasters with 90 questions in 9 domains which is codified by the World Health Organization, in the form of interviews and observing evidences , and if necessary a numerical analysis. Initially, the situation was measured according to this checklist. In the next stage, a set of solutions was developed and then the solutions were implemented according to the obtained information. Data analysis before and after proposing the procedure and its application in order to improve the quality of health management performance and emergency preparedness was performed using central indices, and for describing and presenting the survey&nbsp; results, tables and graphs were used. Results: The highest and lowest emergency preparedness rates for disasters and emergencies before the proposed procedure were the Communication Factor (%77/8) and Human resource factor (%2/8) respectively. The degree of preparedness of the medical center was measured in the management performance according to the model (WHO) before proposing the procedure (%77.98). The researcher's procedure provided and applied based on the information obtained from survey environment, location and type of hospital structure. After providing the procedure, the maximum and minimum rates were the continuity of service factor (%58.3) and post-accident rebuilding factor (%100), respectively. Generally, the rate of emergency preparedness of studied medical center in management performance for coping with disasters and medical emergencies was measured (%97.2) according to hospital emergency responsiveness test for accidents and (WHO). &nbsp;The significance level is less than 0.05, so we can say that the effectiveness with confidence (95%) was effective. Conclusion: According to the statistics of accidents and disasters in the suburb cities, the results of the research and the importance of the role of emergency departments in interurban hospitals in controlling accidents, the need for planning and implementation of practical measures such as conducting training courses on health management in disasters and emergencies, having an estimate of critical and essential resources, changing the structure, providing manpower (emergency management) in order to more precise control and ease of service, maintenance and repair of equipment, timely triage and retrofitting of hospitals were effective in improving their preparedness.

scholarly journals Implementation of strength-based case management for opioid-dependent patients presenting in medical emergency departments: rationale and study design of a randomized trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Amber Regis ◽  
Sarah E. Meyers-Ohki ◽  
Sarah E. Mennenga ◽  
Peter P. Greco ◽  
Richard Glisker ◽  
...  
Keyword(s):  
Case Management ◽  
Randomized Trial ◽  
Study Design ◽  
Emergency Departments ◽  
Medical Emergency ◽  
Strength Based

scholarly journals Evaluation of the Levels and Quality of Microbial Contamination in Medical Emergency Departments in Comparison to Other Workplaces

2016 ◽  
Vol 65 (4) ◽  
pp. 465-469
Author(s):  
Agata Bielawska-Drózd ◽  
Bożena Wlizło-Skowronek ◽  
Piotr Cieślik ◽  
Izabela Winnicka ◽  
Ewa Skopińska-Różewska ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Pathogenic Bacteria ◽  
Microbial Contamination ◽  
Sampling Method ◽  
Medical Emergency ◽  
Ward Staff ◽  
Hospital Emergency ◽  
Emergency Ward ◽  
Hospital Emergency Departments

Work in Hospital Emergency Departments (HEDs) exposes both the emergency ward staff and patients to infectious and in other way harmful biological agents. The results of this study shows the presence of pathogenic bacteria isolated by three different methods. It revealed 9.8% of pathogens detected by imprint method, 10.5% of pathogens by swabbing method, 17.6% and 22% in HEDs corridors and rooms, respectively, by air sampling method. In control workplaces (offices) pathogenic bacteria reached the level of 6.5% and 14.7% by imprint method and swabbing, respectively. The relatively low level of contamination by bacteria in HEDs may depend on the effectiveness of Standard Protective Precautions in the studied hospitals.

Predictors of Depression in Geriatric Medically Ill Inpatients

2001 ◽  
Vol 31 (1) ◽  
pp. 1-8 ◽  
Author(s):  
L. Borin ◽  
K. Menon ◽  
A. Raskin ◽  
P. Ruskin
Keyword(s):  
Life Satisfaction ◽  
Functional Disability ◽  
Medical Center ◽  
Veteran Administration ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Severity Of Illness ◽  
Veteran Administration Medical ◽  
Medically Ill ◽  
Predictors Of Depression

Objective: Depression in medically ill inpatients has been associated with increased morbidity and mortality. The purpose of this study was to identify variables that would successfully predict depression in this population. Methods: The sample consisted of 314 male, medically ill veterans, age 60 and older, admitted to the acute medical service at Baltimore Veteran Administration Medical Center. Sixty of 314 patients met criteria for Major Depression and scored 11 or higher on the Geriatric Depression Scale. Variables assessing age, race, social support, severity of illness, degree of functional disability, life satisfaction, and hopelessness were included in a logistic regression analysis as predictors of depression. Results: The variables that significantly predicted depression were derived from the Beck Hopelessness Scale, Life Satisfaction Score, and the Cumulative Illness Rating Score. Conclusions: The results indicated that medically ill inpatients who feel hopeless about the future, feel the best years of their lives are behind them, and have serious medical problems are likely to be clinically depressed.

scholarly journals An updated national survey of triage and triage related work in Sweden: a cross-sectional descriptive and comparative study

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Sara C. Wireklint ◽  
Carina Elmqvist ◽  
Katarina E. Göransson
Keyword(s):  
Emergency Departments ◽  
Formal Education ◽  
Scientific Evidence ◽  
Treatment System ◽  
Medical Emergency ◽  
National Guidelines ◽  
Cross Sectional ◽  
National Surveys ◽  
Time Frames ◽  
Triage Level

Abstract Background Triage and triage related work has been performed in Swedish Emergency Departments (EDs) since the mid-1990s. According to two national surveys from 2005 to 2011, triage was carried out with different triage scales and without guidelines or formal education. Furthermore, a review from 2010 questioned the scientific evidence for both triage as a method as well as the Swedish five level triage scale Medical Emergency Triage and Treatment System (METTS); nevertheless, METTS was applied in 65% of the EDs in 2011. Subsequently, METTS was renamed to Rapid Emergency Triage and Treatment System (RETTS©). The hypothesis for this study is that the method of triage is still applied nationally and that the use of METTS/RETTS© has increased. Hence, the aim is to describe the occurrence and application of triage and triage related work at Swedish Emergency Departments, in comparison with previous national surveys. Methods In this cross-sectional study with a descriptive and comparative design, an electronic questionnaire was developed, based on questionnaire from previous studies. The survey was distributed to all hospital affiliated EDs from late March to the middle of July in 2019. The data was analysed with descriptive statistics, by IBM SPSS Statistics, version 26. Results Of the 51 (75%) EDs partaking in the study, all (100%) applied triage, and 92% used the Swedish triage scale RETTS©. Even so, there was low concordance in how RETTS© was applied regarding time frames i.e., how long a patient in respective triage level could wait for assessment by a physician. Additionally, the results show a major diversion in how the EDs performed education in triage. Conclusion This study confirms that triage method is nationally implemented across Swedish EDs. RETTS© is the dominating triage scale but cannot be considered as one triage scale due to the variation with regard to time frames per triage level. Further, a diversion in introduction and education in the pivotal role of triage has been shown. This can be counteracted by national guidelines in what triage scale to use and how to perform triage education.

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