Utilization of technology: unrealized potential
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, Pa. [u.a.]
Saunders
1999
|
| Schriftenreihe: | Critical care nursing clinics of North America
11,1 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XIV, 120 S. Ill., graph. Darst. |
Internformat
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Datensatz im Suchindex
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| adam_text | Utilization of Technology:
Unrealized Potential
Contents
Foreword xi
Suzanne S. Prevost
Preface xiii
Tom Ahrens
Role of Technology in Achieving Clinical and Cost Impact in
Acute and Critical Care 1
Tom Ahrens
Advances in technology in the critical care environment play a vital role in potentially reducing
morbidity and mortality; however, technological advances can often he controversial. For example,
without adequate training in these new technologies, clinicians are not adept at utilizing these
advances. This often leads to unrealized potential and wasted funds. This article introduces current
use of technology in the intensive care unit (1CU) and reviews the current problems associated with
such advances including possible ways to improve the learning process within the ICl .
Advances in Artificial Airway Management 7
Robert E. St. John
Maintenance of a patent airway that allows adequate gas exchange is fundamental to the management
of any critically ill patient. In the intensive care setting, a number of artificial airways are used clinically,
such as oral and nasopharyngeal airways, and cuffed or uncuffed tracheal tubes. This article reviews
some of the current trends in airway management practices, while discussing technologic advances
in adult tracheal lube design in the critically ill patient.
Hemodynamic Monitoring 19
Tom Ahrens
Hemodynamic monitoring, specifically the right heart or Swan Ganz catheter, is often criticized for
failing to achieve a measurable benefit for patients receiving this technology. However, this criticism
is really a comment on the skill of the clinicians who use hemodynamic monitoring. If hemodynamie
monitoring is used appn iprtately. as identified in this article, a positive impact m patient management
will be measurable.
Continuous Mixed Venous (Svo2) Monitoring: Too Expensive
or Indispensible 33
Tom Ahrens
Svoj catheters cost more than traditional pulmonary artery (PA) catheters, a factor that has limited
their acceptance as the standard PA catheter. The added cost of the Svo, catheter has not been
CRITICAL CARE NURSING CLINICS OF NORTH AMERICA
Volume 11 / Number 1 / March 1999 vii
adequately addressed in the research literature. However, research does support that Svo2 allows
more rapid termination of drug therapies, may improve timely movement out of the intensive care
unit and reduces the incidence of mechanical ventilator manipulation. These features increase the
cost effectiveness of Svo2 catheters and like any technology, cost effectiveness is predicated on the
clinician. Clinicians must be educated to use Svo_. as a primary end point for treatment decisions
regarding hemodynamic therapy and patient stability. If used properly, ever) PA catheter should
have fiberoptic Svo^ capabilities.
Capnography: A Key Underutilized Technology 49
Tom Ahrens, Helen Wijeweera, and Shawn Ray
Capnography is one of the most underutilized technologies in acute and critical care. It is a simple,
non invasive, and accurate method for identifying placement of endotracheal and nasogastric tubes
and an end point in cardiopulmonary resuscitation. In addition, capnography has several other
applications that can be successfully implemented with the appropriate education of clinicians. When
used appropriately, capnography is a highly cost effective technology that has a place in every acute
and critical care area.
Advances in Continuous, Noninvasive Hemodynamic Surveillance:
Impedance Cardiography 63
Kathryn T. Von Rueden and Maureen A. Turner
Until recently, hemodynamic monitoring has been limited primarily to invasive data acquisition via
a pulmonary artery catheter at the bedside or in the cardiac catheterization laboratory. Noninvasive
hemodynamic monitoring via impedance cardiography (thoracic electrical bioimpedance) has under¬
gone technological advances and is now an acceptable means of assessing and managing hemody¬
namic and thoracic fluid status. Impedance cardiography has been studied, not only in the critical
care arena, but also in other areas of the hospital, and in outpatient and home care arenas. This article
describes available impedance cardiography technologies and addresses the utility and appropriate use
of impedance cardiography vising the framework for technology assessment.
Telemetry Monitoring in Acute and Critical Care 77
Nelda Martin and Patty Hendrickson
With the expansion of higher acuity patients in non critical care areas, the perceived need for telemetry
monitoring has escalated Many factors must be kept in mind for institutions pursuing this expansion
including: patient criteria for telemetry initiation and discontinuation, staff competency of ECG interpre¬
tation, safety, technology required, usability, and cost effectiveness. All these issues will be addressed
in this article. In addition, the components of the monitoring system will also be explained to equip
the reader with the information needed to implement and evaluate a telemetry system.
Pulse Oximetry 87
Tom Ahrens and Kim Tucker
Pulse oximetry is so widespread in its application that it is sometimes referred to as the fifth vital
sign. This widespread use has allowed clinicians to continuously monitor pulmonary function, avoid
obtaining unnecessary arterial blood gases, and make sophisticated assessments of respiratory function.
However, clinicians have not taken advantage of its real potential, primarily due to lack of knowledge.
While pulse oximetry is accurate, easy to use, and valuable in clinical assessments, its real impact
will not be known until bettor utilization occurs.
Point of Care Testing in Critical Care 99
Lynn Schallom
Point f care testing (POCT) has experienced considerable growth over the past two decades especially
in the critical care areas. Examples of currently available POCT include arterial blood gases, electri ilytes,
and hemoglobin and hematocrit levels. These analyses are made with one to two drops of blood or
via continuous non invasive or invasive sampling. However, before any new POCT is accepted it
needs to be evaluated for accuracy, clinical impact, and cost/benefit. This article provides the reader
with guidelines and questions to use during the evaluation process of POCT.
Viii CONTENTS
Outlier Management: Influencing the Highest Resource
Consuming Areas in Acute and Critical Care 107
Tom Ahrens
The cost of technology needs to be balanced against the potential benefit to be achieved in the
management of acute and critically ill patients. Although technology can be expensive, it is important
that clinicians realize that controlling costs is not the primary focus of a clinicians evaluation of
technologies and their uses. A substantial portion of hospital resources is spent on a few patients
(called outliers) who consume disproportionally high technological (and other) resources. Improving
the management of outliers helps bring the benefit of technology into a better perspective.
Index 117
Subscription Information Inside back cover
CONTENTS IX
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| spelling | Utilization of technology unrealized potential Tom Ahrens, guest ed. Philadelphia, Pa. [u.a.] Saunders 1999 XIV, 120 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Critical care nursing clinics of North America 11,1 Soins infirmiers Technologie Nursing trends Technology trends Kosten-Nutzen-Analyse (DE-588)4032589-1 gnd rswk-swf Patientenüberwachung (DE-588)4115513-0 gnd rswk-swf Intensivmedizin (DE-588)4027263-1 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Intensivmedizin (DE-588)4027263-1 s Patientenüberwachung (DE-588)4115513-0 s Kosten-Nutzen-Analyse (DE-588)4032589-1 s DE-604 Ahrens, Tom Sonstige oth Critical care nursing clinics of North America 11,1 (DE-604)BV011338306 11,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008479543&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Utilization of technology unrealized potential Critical care nursing clinics of North America Soins infirmiers Technologie Nursing trends Technology trends Kosten-Nutzen-Analyse (DE-588)4032589-1 gnd Patientenüberwachung (DE-588)4115513-0 gnd Intensivmedizin (DE-588)4027263-1 gnd |
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| title | Utilization of technology unrealized potential |
| title_auth | Utilization of technology unrealized potential |
| title_exact_search | Utilization of technology unrealized potential |
| title_full | Utilization of technology unrealized potential Tom Ahrens, guest ed. |
| title_fullStr | Utilization of technology unrealized potential Tom Ahrens, guest ed. |
| title_full_unstemmed | Utilization of technology unrealized potential Tom Ahrens, guest ed. |
| title_short | Utilization of technology |
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| title_sub | unrealized potential |
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