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Auteur Elizabeth G. Zolper
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Ajouter le résultat dans votre panier Affiner la rechercheEnsuring Quality Care in the COVID-19 Era Applying the Donabedian Model to Tertiary Wound Care Center Practices / Karen K. Evans in Journal of the American Podiatric Medical Association, vol. 113, 02 (Mars 2023)
[article]
in Journal of the American Podiatric Medical Association > vol. 113, 02 (Mars 2023)
Titre : Ensuring Quality Care in the COVID-19 Era Applying the Donabedian Model to Tertiary Wound Care Center Practices Type de document : article de périodique Auteurs : Karen K. Evans ; Jenna C. Bekeny ; Elizabeth G. Zolper ; John S. Steinberg ; Jayson Atves ; Carol Deane Benedict ; Kenneth L. Fan ; Cameron M. Akbari ; Christopher Attinger Année de publication : 2023 Langues : Anglais (eng) Descripteurs (mots clés) : [Thésaurus Mesh]Cicatrisation de plaie
[Thésaurus Mesh]COVID-19
[Thésaurus Mesh]Pied diabétique
[Thésaurus Mesh]Plaies et blessures
[Thésaurus Mesh]Qualité des soins de santéMots-clés : modèle Donabedian Résumé : The coronavirus disease of 2019 pandemic has disrupted health care, with its far-reaching effects seeping into chronic disease evaluation and treatment. Our tertiary wound care center was specially designed to deliver the highest quality care to wounded patients. Before the pandemic, we were able to ensure rapid treatment by means of validated protocols delivered by a colocalized multidisciplinary team within the hospital setting. The pandemic has disrupted our model’s framework, and we have worked to adapt our workflow without sacrificing quality of care. Using the modified Donabedian model of quality assessment, we present an analysis of prepandemic and intrapandemic characteristics of our center. In this way, we hope other providers can use this framework for identifying evolving problems within their practice so that quality care can continue to be delivered to all patients Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
Cote Support Localisation Section Disponibilité aucun exemplaire A Focus on Amputation Level: Factors Preventing Length Preservation in the National Inpatient Sample / Kenneth L. Fan in Journal of the American Podiatric Medical Association, vol. 112, 01 (Janvier - mars 2022)
[article]
in Journal of the American Podiatric Medical Association > vol. 112, 01 (Janvier - mars 2022)
Titre : A Focus on Amputation Level: Factors Preventing Length Preservation in the National Inpatient Sample Type de document : article de périodique Auteurs : Kenneth L. Fan ; Jenna C. Bekeny ; Christopher Kennedy ; Elizabeth G. Zolper ; John S. Steinberg ; Christopher Attinger ; Karen K. Evans ; Derek DeLia Année de publication : 2022 Langues : Anglais (eng) Descripteurs (mots clés) : [Thésaurus Mesh]Amputation chirurgicale
[Thésaurus Mesh]Cheville
[Thésaurus Mesh]Genou
[Thésaurus Mesh]Mortalité
[Thésaurus Mesh]Pied diabétique
[Thésaurus Mesh]Ulcère du pied
[Thésaurus HELB]:Paramédical:Avant piedRésumé : Background: Diabetic lower-extremity disease is the primary driver of mortality in patients with diabetes. Amputations at the forefoot or ankle preserve limb length, increase function, and, ultimately, reduce deconditioning and mortality compared with higher-level amputations, such as below-the-knee amputations (BKAs). We sought to identify risk factors associated with amputation level to understand barriers to length-preserving amputations (LPAs).
Methods: Diabetic lower-extremity admissions were extracted from the 2012-2014 National Inpatient Survey using ICD-9-CM diagnosis codes. The main outcome was a two-level variable consisting of LPAs (transmetatarsal, Syme, and Chopart) versus BKAs. Logistic regression analysis was used to determine contributions of patient- and hospital-level factors to likelihood of undergoing LPA versus BKA.
Results: The study cohort represented 110,355 admissions nationally: 42,375 LPAs and 67,980 BKAs. The population was predominantly white (56.85%), older than 50 years (82.55%), and male (70.38%). On multivariate analysis, living in an urban area (relative risk ratio [RRR] = 1.48; P < .0001) and having vascular intervention in the same hospital stay (RRR = 2.96; P < .0001) were predictive of LPA. Patients from rural locations but treated in urban centers were more likely to receive BKA. Minorities were more likely to present with severe disease, limiting delivery of LPAs. A high Elixhauser comorbidity score was related to BKA receipt.
Conclusions: This study identifies delivery biases in amputation level for patients without access to large, urban hospitals. Rural patients seeking care in these centers are more likely to receive higher-level amputations. Further examination is required to determine whether earlier referral to multidisciplinary centers is more effective at reducing BKA rates versus satellite centers in rural localities.Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
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