...this convenience and the ever evolving technology comes the burden of cost on the U.S. economy. This paper will review how early medicinal practices have evolved into the technologically advanced world of medicine we live in today, as well as discuss how these advancements play a role in the accessibility, affordability and quality of life and care the patients of the United States receive today. In the early 1800’s, medicinal practice in the U.S. was considered to be very primitive. Unlike the European countries of Britain, France and Germany, “American medicine lagged behind in the advances of medical science, experimental research and medical science education” (Shi & Singh, 2008 p. 85). Instead, America focused more on applied science rather than the research of basic sciences. In return, the United States’ “early practices of medicine were regarded more as a trade than a profession. It did not require the rigorous course of study, clinical practice, residency training, board exams and licensing, without which it is impossible to practice today” (Shi & Singh, 2008 p.85). This meant that pretty much anyone during this time could call themselves a physician, and so they did. In the early 1800’s tradesmen, barbers and merchants were involved in healing by selling herbal prescriptions, elixirs, cathartics and nostrums. Barber’s at the time would also function as surgeons, using the same blade to cut hair, shave beards and bleed the sick (Shi & Singh, 2008 p.85). They...
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...Abusive head trauma (AHT), also called shaken baby syndrome, is a traumatic brain injury to a child as a result of child abuse. Shaking as well as throwing a baby constitutes AHT. When a caretaker forcefully shakes a baby, his or her head muscles will rotate in a circular motion as their head whips back and forth. Impact is especially damaging because the fast acceleration and deceleration is very dangerous and causes blood vessels to rupture, tearing in the brain, and bleeding of the brain. AHT is the most common cause of traumatic brain injury in infants. Around 25% of victims die from AHT. Infants are at a high risk of AHT due to their large head size relative to the rest of their body and their inability to support their head with their...
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... Inc Abstract / Executive Summary Intuitive Surgical continues to lead the surgical robotic market in both market penetration and revenue stream. This company continues its reach to surgeons and patients globally through its opportunity to offer minimally invasive solutions with latest technology. Faced with environmental changes and new competition on the horizon, Intuitive Surgical has some challenges to face while maintaining positive results for investors. Overview This paper is based on research performed on Intuitive Surgical Inc, (NASDAQ: ISRG) and includes details about company’s line of business, place within its industry, and overall business situation as it is perceived by its customer based. Certain company financials will be introduced, analyzed, and discussed throughout the paper to help describe the perspective of value that this company has to investors and consumers alike. An industry analysis will help explain the strengths, weaknesses, and challenges this company faces amidst policy changes and increasing competition. Line of Business and Overall Business Situation Intuitive Surgical, Inc. is a leader in minimally invasive robotic-assisted surgery and competes in the global market. This company has capitalized on the growing demand from surgeons and patients desiring minimally invasive procedures across many surgical disciplines. In January of 1999, the da Vinci System was launched and was the first robotic surgical system cleared by...
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...By the 1970s, the thought process behind ACL reconstruction took a more mechanical based approach. Doctors began to conduct strength testing on the various ligaments comprising the knee joint in order to better understand the respective roles of the ligaments involved (6), (7). Through the research published in The Journal of Bone and Joint Surgery by John Kennedy and Peter Flower, it was learned that the medial capsular ligament and tibial collateral ligament failed under rotational loading prior to failure of the ACL (7). Even though the results definitively suggested that ACL failure was induced by isolated trauma, the surgical advancements developed in the era were predicated around resolving the rotational instability of the...
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...Explain herd immunity. • What is the required percentage of people who need to be vaccinated to ensure that a major measles epidemic does not occur? What was the percentage in France in 2007 -2008? How big was the epidemic that followed? 95%, 89%, 15,000 cases in 2011 • What caused Luke Filben’s neurological disorder? A gene mutation causes Dravet syndrome • damaged by traumas, infections, heredity and tumors, among other things. Some pediatric neurological disorders are caused by exposure to toxic chemicals and development delays. • What is the difference between a cause of a disease and a trigger for a disease? A cause of disease its what actually makes it into the disease and a trigger for a disease it’s what spreads it and starts the disease. • Can today’s polio vaccine cause polio? yes • Why do some people think that vaccines cause autism? Autism symptoms are usually noticed around the same time that many vaccinations are given • Who was Andrew Wakefield and what did he have to do with the way many people see vaccines? Andrew Jeremy Wakefield is a British former surgeon and medical researcher,...
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...State of Advance Practice Paper There are many definitions of advanced practice nursing. Nursing’s Scope and Standards of Practice (ANA, 2014) defines APNs as having advanced specialized clinical knowledge and skills through master’s or doctoral education that prepares them for specialization, expansion, and advancement of practice. Specialization is concentrating or limiting one’s focus to part of the whole field of nursing. Expansion refers to the acquisition of new practice knowledge and skills, including knowledge and skills legitimizing role autonomy within areas of practice that overlap traditional boundaries of medical practice. Advancement involves both specialization and expansion and is characterized by the integration of theoretical, research-based, and practical knowledge that occurs as part of graduate education in nursing. APN is an umbrella term for the four roles mentioned earlier: clinical nurse specialist (CNS), certified registered nurse anesthetist (CRNA), certified nurse-midwife (CNM), and nurse practitioner (NP) (Sheer, & Wong, 2008). Each role is distinguishable from the others, but in some respects they overlap. This APN definition encompasses nurses engaged in clinical practice; it does not include nurses with advanced preparation for administration, education, or research (ANA, 2014). Only recently has the expectation arisen that APNs should receive their education within master’s or doctoral nursing programs. Although CNSs have always required master’s...
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...Priority Focus Area: Communication In preparation of a review from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Nightingale Community Hospital will focus on improving its communication process in the operating room. The purpose of communication in the healthcare setting is to disseminate information in such a way as to create shared understanding about the patient and about what needs to be done for a positive outcome. (synergia.com) A patient is at his most vulnerable state during procedures that require sedation or anesthesia. The patient is releasing his decision making ability and safety into the control and care of the healthcare team. Therefore, effective communication on behalf of the patient is critical to the patient’s outcome. As we prepare for this upcoming review by the Joint Commission, communication is our priority focus area. From a previous Joint Commission visit 2 years ago it was found that Nightingale Community Hospital fell short in the area of communication. In one instance the surveyor was unable to find the link between the interdisciplinary and collaborative process that the hospital already had in place to the actual usage of the process to affect patient outcomes. (PC.01.03.01) It was also found that leadership had not effectively communicated how the hospital manages its programs, services, sites or departments as evidenced by an interview with three different staff nurses. (LD.04.01.05) Lastly, as it relates...
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...succeed due to the lack of market research. Successful innovations often disrupt an established technology, meaning that the established technology becomes obsolete, or much less used, and it us the disruptive innovation which takes over. In this paper we will see how Robotic surgery disrupts the traditional human surgery process. Robotic surgery offers small incisions, instruments that bend further than the human wrist, and an enhanced view due to its magnified 3D high-definition. It is highly beneficial due to its reduced chance of bleeding and infection, fewer post-operative complications and a faster recovery. The only commercialized robot in robotic surgery is the Da Vinci surgical robot, which is a production of Intuitive Surgical. The medical domain has already accepted a lot of innovations, it is a domain that has greatly evolved, our health being one of the most important things in life, a lot of research is made around it, and the government is often part in its funding’s. The most revolutionary innovation in the health care center is robotic surgery, which now looks to disrupt the human procedure of surgery, and replace it with robotic surgery. Robotic surgery however still demands the help of surgeons, who are needed to control the da Vinci, the surgeons operate virtually behind a computer station where they can guide the various arms of the robot, and assist the surgery through a magnified 3D high-definition screen. Thus, surgeons have to be trained to use...
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...Using Simulation Modeling to Improve Patient Flow at an Outpatient Orthopedic Clinic Thomas R. Rohleder, PhD Division of Health Care Policy and Research Mayo Clinic 200 First Street SW Rochester, Minnesota 55905 tel: 507-538-1532 Email: rohleder@mayo.edu Peter Lewkonia, MD Faculty of Medicine University of Calgary Calgary, Alberta Diane Bischak, PhD Haskayne School of Business University of Calgary Calgary, Alberta Paul Duffy, MD Faculty of Medicine University of Calgary Calgary, Alberta Rosa Hendijani Haskayne School of Business University of Calgary Calgary, Alberta July 2011 Abstract We report on the use of discrete event simulation modeling to support process improvements at an orthopedic outpatient clinic. The clinic was effective in treating patients, but waiting time and congestion in the clinic created patient dissatisfaction and staff morale issues. The modeling helped to identify improvement alternatives including optimized staffing levels, better patient scheduling, and an emphasis on staff arriving promptly. Quantitative results from the modeling provided motivation to implement the improvements. Statistical analysis of data taken before and after the implementation indicate that waiting time measures were significantly improved and overall patient time in the clinic was reduced. Keywords: Outpatient Clinic, Discrete Event Simulation, Process Improvement, Patient Waiting I. Introduction Visiting hospital outpatient clinics is a very common way for...
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...Using Simulation Modeling to Improve Patient Flow at an Outpatient Orthopedic Clinic Thomas R. Rohleder, PhD Division of Health Care Policy and Research Mayo Clinic 200 First Street SW Rochester, Minnesota 55905 tel: 507-538-1532 Email: rohleder@mayo.edu Peter Lewkonia, MD Faculty of Medicine University of Calgary Calgary, Alberta Diane Bischak, PhD Haskayne School of Business University of Calgary Calgary, Alberta Paul Duffy, MD Faculty of Medicine University of Calgary Calgary, Alberta Rosa Hendijani Haskayne School of Business University of Calgary Calgary, Alberta July 2011 Abstract We report on the use of discrete event simulation modeling to support process improvements at an orthopedic outpatient clinic. The clinic was effective in treating patients, but waiting time and congestion in the clinic created patient dissatisfaction and staff morale issues. The modeling helped to identify improvement alternatives including optimized staffing levels, better patient scheduling, and an emphasis on staff arriving promptly. Quantitative results from the modeling provided motivation to implement the improvements. Statistical analysis of data taken before and after the implementation indicate that waiting time measures were significantly improved and overall patient time in the clinic was reduced. Keywords: Outpatient Clinic, Discrete Event Simulation, Process Improvement, Patient Waiting I. Introduction Visiting hospital outpatient...
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...The two main classifications are Acute and Chronic Renal Failure. Acute Renal Failure is best defined as rapid and new onset renal failure sometimes reversible when treated appropriately while Chronic Renal Failure long term and irreversible unless treated via transplant. Now that a basic foundation definition of Renal Failure has been established, one must gain knowledge of what causes Renal Failure. Now that there is a basic understanding to what Renal Failure is the next step is to find out causes of the disease. This is where Acute Renal Failure (ARF) and Chronic Renal Failure (CRF) start to really differ. ARF can be caused by many disease processes or injuries such as; dehydration, rhabdomyolysis, trauma, renal infection, drug toxicity, and sepsis. In fact research conducted by the staff at the...
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...(MRSA) has been identified as a significant risk factor for patients undergoing orthopedic surgery, putting this patient at a higher risk of developing a surgical site infection. Screening preoperatively and treating colonization is a tool to aid in the prevention of surgical site infections in patients undergoing elective joint surgery. Results of various studies of patients undergoing elective joint replacement surgery have been reviewed. A nasal swab was obtained and cultured during preadmission testing. If the culture showed that the patient was positive for MRSA colonization they were treated with nasal mupirocin. They also were instructed to bathe with surgical wipes containing chlorhexidine prior to the procedure. The results of the research suggest that the use of a screening protocol prior to surgery can decrease the risk of MRSA in the postoperative patient. Table of Contents 1. Literature Review........................................................................................................................4 2. Discussion....................................................................................................................................7 3. Conclusion...................................................................................................................................8 4. References .................................................................................................................................10 5....
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... 74 % | b. Verification | 3 | 255 | 765 | 9 | 4 | 32 | 48 | 288 | 192 | 480 | 63 % | 2. Radiology Department | | | | | | | | | | | | a. X-ray imaging | 6 | 240 | 9603 | 11 | 11 | 32 | 40.8 | 352 | 448.8 | 800.8 | 83 % | b. Development of X-rat | -1 | 240 | 9604 | 7 | 7 | 32 | 40.8 | 224 | 285.6 | 509.6 | 53%8 | c. Diagnostic reading and comments | 3 | 240 | 4805 | 5 | 5 | 32 | 40.8 | 160 | 204 | 364 | 76% | 3. Hand-off X-ray to Clinic | | | | | | | | | | | | a. Collection of X-ray | 3 | 2556 | 7657 | 2 | 2 | 32 | 40.8 | 64 | 81.6 | 145.6 | 19% 9 | b. Filing/exam room prep | 1 | 255 | 255 | 2 | 2 | 32 | 48 | 64 | 96 | 160 | 63% | 4. Examination Room | | | | | | | | | | | | a. Surgeon | 1 | 255 | 255 | 7 | 4 | 32 | 14.4 | 224 | 57.6 | 281.6 | 110% | b. Resident | 1(2)2 | 255 | 255 | - | 7 | - | 33.6 | - | 235.2 | 235.2 | 92% | c. Cast technician | 1 | 255 | 255 | 17 | 13 | 8 | 7.2 | 136 | 93.6 | 229.6 | 90% | 1- It’s an automatic activity 2- There are two senior resident students, but in a current time only one of them is working. 3-4-5 The current available time (in total) for these activities is: a. = 1440; b. 1440; c. = 720. But since Paediatric Orthopaedic Clinic use these activities only 2/3 of the total time they are...
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...BRIEF COMMUNICATION Clinical Telehealth Across the Disciplines: Lessons Learned Sandra Jarvis-Selinger, Ph.D.,1,2 Elmira Chan, M.Ed.,2 Ryan Payne, B.A.,2 Kerenza Plohman, LLM,2 and Kendall Ho, M.D., FRCPSC2,3 cost and remuneration issues, development of organizational protocols for system use, and strategies to promote interprofessional collaboration). 1 Department of Surgery, 2Division of Continuing Professional Development and Knowledge Translation, 3Division of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada. Key words: clinical telehealth, videoconferencing, literature review, quality of service Introduction Abstract Videoconferencing technologies can vastly expand the reach of healthcare practitioners by providing patients (particularly those in rural/remote areas) with unprecedented access to services. While this represents a fundamental shift in the way that healthcare professionals care for their patients, very little is known about the impact of these technologies on clinical workflow practices and interprofessional collaboration. In order to better understand this, we have conducted a focused literature review, with the aim of providing policymakers, administrators, and healthcare professionals with an evidence-based foundation for decision-making. A total of 397 articles focused on videoconferencing in clinical contexts were retrieved, with 225 used to produce this literature review. Literature in the fields...
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...LAS 432 Course Capstone Project Robotic Surgery (LAS 432 - 08) Robert Clark April 19, 2015 Team F Team Leader: Dylan Zinkiewicz - D# 03342318 Team Members: Alisha Young - D# 01615918 Antonice Thomas - D# 01487783 Brooke White - D# 01489597 Katherine Vega - D# 01487783 Contents Alisha Young Intro to Robotic Surgery 2 Antonice Thomas Timeline 10 Overview 15 The Future 17 Dylan Zinkiewicz Economic Talk 19 Marketing & Media Influence 24 Katherine Vega Psychological considerations and Sociological effects 29 Environmental Implications 33 Brooke White Ethics and Legal Issues 37 Conclusion 45 References 46 Intro to Robotic Surgery Robotic surgery is defined in the medical dictionary as "the performance of operative procedures with the assistance of robotic technology" ("Robotic," n.d.). Robotic surgery is an emerging technology that began its experimental phase in 1985 with the introduction of the PUMA 560 robotic arm. The first use of a robot for a surgical procedure was a neurosurgical biopsy, recorded in 1985. Following this successful surgery was the first laparoscopic surgery using the same kind of robot; the robotic arm. In 1987, a successful cholecystectomy was performed. In 1988, doctors decided to use the PUMA 560 robotic arm for a transurethral resection procedure. Finally, in 1990, the Automated Endoscopic System for Optimal Positioning (AESOP) became known as the first system to be approved by the Food and...
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