Asunto(s)
Relaciones Interprofesionales , Enfermeras Administradoras/organización & administración , Supervisión de Enfermería/organización & administración , Grupo de Atención al Paciente/organización & administración , Humanos , Internacionalidad , Liderazgo , Enfermería/organización & administración , Enfermería/normas , Personal de Enfermería en Hospital , Reino UnidoAsunto(s)
Bachillerato en Enfermería/organización & administración , Educación Continua en Enfermería/organización & administración , Enfermeras Administradoras/organización & administración , Personal de Enfermería/educación , Desarrollo de Personal/organización & administración , Necesidades y Demandas de Servicios de Salud , Humanos , Rol de la Enfermera , Personal de Enfermería/organización & administración , Personal de Enfermería/psicología , Selección de Personal/organización & administración , Preceptoría/organización & administraciónRESUMEN
PURPOSE: Evidence is needed to guide NICU use of lansoprazole (Prevacid), ranitidine (Zantac), and metoclopramide (Reglan). As a step toward that goal, we conducted a historic cohort analysis of all patients who received any of these medications in 4 Intermountain Healthcare NICUs during the year 2006. SUBJECTS: Data were obtained from all patients admitted between January 1 and December 31, 2006, to any of 4 Intermountain Healthcare NICUs. DESIGN: This was a retrospective descriptive design. METHODS: Data were obtained from electronic pharmacy records and electronic medical records. The NICUs involved were blinded and included McKay-Dee Hospital Center, Ogden, Utah; LDS Hospital, Salt Lake City, Utah; Utah Valley Regional Medical Center, Provo, Utah; and Dixie Regional Medical Center, St George, Utah. RESULTS: Although the demographics of the patients at the 4 centers were similar, significant differences were seen among the centers in drug use patterns. Lansoprazole use ranged from a high of 17% of patients in one center to a low of 7% of patients in another. Ranitidine use ranged from 9% in one center to 1% in another. Metoclopramide use ranged from 9% of patients in one center to <1% in another. CONCLUSIONS: The extreme variability among the centers in use patterns of these 3 medications suggests lack of an adequate evidence base to guide practice and indicates that case controlled studies or random controlled trials are needed to devise a consistent evidence-based approach.
Asunto(s)
2-Piridinilmetilsulfinilbencimidazoles/uso terapéutico , Monitoreo de Drogas/estadística & datos numéricos , Reflujo Gastroesofágico/tratamiento farmacológico , Registros Médicos/estadística & datos numéricos , Metoclopramida/uso terapéutico , Pautas de la Práctica en Medicina/estadística & datos numéricos , Ranitidina/uso terapéutico , Antiulcerosos/uso terapéutico , Adhesión a Directriz , Hospitales Comunitarios/organización & administración , Hospitales de Enseñanza/organización & administración , Humanos , Recién Nacido , Unidades de Cuidado Intensivo Neonatal/estadística & datos numéricos , Lansoprazol , Inhibidores de la Bomba de Protones/uso terapéutico , Estudios Retrospectivos , Utah/epidemiologíaRESUMEN
The size of cells, tissues and organisms is a fundamental yet poorly understood attribute of biological systems. Traditional difficulties in interrogating the basis for size regulation have been surmounted by recent systematic phenotypic analyses. Genome-wide size screens in yeast suggest that ribosome biogenesis rate dictates cell size thresholds, whereas analogous RNAi-based size screens in metazoans cells reveal further connections between cell size and translation, as well as myriad other pathways. Sophisticated genetic screens in flies have delineated the new Hippo-signalling pathway that controls tissue and organ size. While the plethora of genes that alter size phenotypes at present defies a unified model, systems-level analysis suggests many new inroads into the longstanding enigma of size control.