Abstract Catheterization as a medical technique has been in practice for more than two millennia. While it first began as an experimentation with animals, it gradually became part of human treatments. The procedure of cardiac catheterization in humans was first put to clinical use more than five decades ago and has undergone many changes since then. What was once a purely experimental technique is now one of the most common invasive medical procedures in Europe and North America, with more than eighty-percent of those procedures performed to diagnose suspected heart disease. Animal cardiac catheterization was first accomplished in 1844 with a horse. The characterization of the human heart was first accomplished by a German medical student in 1929. By the 1940's, the practice had become improved and was starting to become common practice in a few hospitals in North America and Europe. By entering a catheter through an arm vein, surgeons were able to reach the atrium of the heart. Today, cardiac catheterization is accomplished with a great deal of skill and technology, but is much easier and less dangerous than when it first was being used. It is the purpose of this paper to examine the history of cardiac catheterization and its import to medicine today.
Abstract This paper provides a business plan to outline the structure, goals and financial aspects of creating a new cardiac catheterization lab and heart treatment center in central Florida. This center is to be called "CardioCenter," and will extend its message of expert urgent cardiac care within a 25-mile radius. The paper covers how such a center should be built, what are its fundamental goals, and how it can compete against established centers in the area. The goal of the new cardiac catheterization center is to provide services to primary care physicians and first-level cardiologists, and to provide faster and more-targeted services to patients who require catheterization and may not be close enough to a major catheterization center.
Outline:
Executive Summary
Mission of the New Center
Strategies of CardioCenter
Mission Statement
Vision Statement
Organizational Structure
Financial Structure
Debt Policy
Assumptions for Growth of the Business
Governance Model
Possible Mergers and Acquisitions
Personnel Needed
Facilities
Program Development
HCIT (Healthcare Information Technology)
SWOT Analysis
Longer-Term Plans
From the Paper "Within central Florida, centered around Orlando, there are three major heart centers with round-the-clock facilities available for cardiac catheterization. These centers advertise their availability, and can tout their ability to improve patients' outcomes by improving "door to balloon" time down to less than 60 minutes. Such a strategy of rapid catheterization has been shown to significantly improve the morbidity and mortality of patients (Bradley, 2006). Although many existing facilities have attempted to adapt their workflow to improve "door to balloon time," many have not, as the structural and schedule changes involved in a general-care hospital pose difficulties. "
An analysis of Coronary CT, explaining why it may eliminate the need for non-interventional heart catheterization, and stands ready to serve as the preliminary choice for diagnostic evaluation of the native coronary vessels.
Abstract The paper explains how our society is increasingly at risk; the number of fatalities each year from coronary artery disease continues to rise in spite of efforts to educate the populace on methods to reduce risk factors. The paper lists the steps that must be taken to identify those individuals at risk and provide them with treatment options. The paper identifies angiography as providing the best method of coronary evaluation available, and lists the three types currently in use: magnetic resonance, catheter, and computed tomography. The paper analyzes the specific benefits and limitations of each type. Of the three, the paper finds that computed tomographic angiography (CTA) provides the greatest versatility and has the least associated risks and limitations, and also provides the greatest volume of information and detail. In conclusion, the paper anticipates that the CTA will likely become the diagnostic tool of choice and ultimately supplant catheter angiography.
From the Paper "The super-sized, rapid paced, high stress society we inhabit contributes daily to the demise of our fellow citizens. The epidemic rise of obesity and diabetes compounds the risk of America's number one killer: heart disease. The number of Americans succumbing to heart disease will nearly double from 500,000 in 2002 to 930,000 in 2005. The cost to treat cardiovascular patients in 2005 will cap at just under $400 billion (Kazerooni, 2005). Emphasis on risk reduction should be made, but it falls short of real impact. Steps must be taken to diagnose patients at risk and provide treatment options appropriate to their level of disease."
Abstract There has been extensive documentation on hospital-acquired infections, and of these, catheter-associated urinary tract infections are the most common. In fact, catheter-related infections account for up to 40% of nosocomial infections. Among those with nosocomial urinary tract infections, 10-20% of patients had genitourinary or urological manipulation, while 80% had placement of a permanent urethral catheter. Despite the significant contribution of urethral catheterization, many patients are inserted with a urinary catheter upon admission to the emergency department without proper justification. The author of the paper suggests a protocol that is evidence-based and that provides evidence that supports the proper identification of patients who must undergo catheterization and limits this to those patients only.
Outline:
Introduction
Define the Problem
Critique Research: Review of Related Literature
Evidence-based Practice Plan
Bibliography
From the Paper "Unlike the intact genitourinary system, indwelling catheters have no innate defense mechanism; hence, biofilm formation occurs. Biofilms consist of microorganisms that adhere together, along with host urinary components such as proteins, electrolytes, and other organic molecules (Trautnere and Daraouiche, 2004). More bacteria attach to this material and thrive on them. Biofilms are found within the catheter lumen and on the external surface of the catheter. Biofilms are difficult to eradicate because they are able to resist being swept away by simple shear forces, resist phagocytosis, and resist antimicrobial agents. Therefore, they continuously flourish until microorganisms reach pathologic levels. The presence of biofilms and their resistance to conventional treatment supports the fact that catheters should be avoided or removed the soonest time possible to reduce the exposure on biofilm infections (Crosby, 2005). Current recommendations for short-term catheterization make use of indwelling catheters that are made of latex rubber, siliconized latex, or plastic. However, it seems that none of these are impervious to biofilm formation. Therefore, it is only rational and supported by studies that catheters are limited only to those who need it."
Abstract This paper proposes research into the issue of the inappropriate use of urinary catheters. The paper points out that, in the past three decades, the major focus of catheter-associated urinary tract infection (CAUTI) prevention research has been evaluation of new devices or materials that will prevent CAUTI. The paper states that a common theme emerging from the literature is that not all indwelling urinary catheters are appropriate for the duration of the catheterization, which places the patient at an increased risk of CAUTI. The proposed study will be administered in a 149 bed rural for-profit hospital using a descriptive, correlation design. Objectives of the mandatory nursing staff education will be to educate all nurses on the relationship of increased catheter days to hospital-acquired urinary tract infection, and to report the findings of the survey. In conclusion, the paper suggests that catheter days be collected over the next three months to determine the effect of the study.
Outline:
Introduction
Significance
Problem Statement
Purpose
Research Question and Research Hypothesis
Definition of Terms
Conceptual Framework
Review of the Literature
Methodology
Ethical Considerations
Measurement Method
Limitations
Communication of Findings
Appendices
From the Paper "Catheter-associated urinary tract infection (CAUTI) has been a leading cause of morbidity and mortality in hospitalized patients (Somwang & Chertsak, 2005). The Centers for Disease Control developed the first guideline for prevention of CAUTI in 1981, and CAUTI has been repsonsible for at least forty percent of healthcare-acquired infection since that time (Centers for Disease Control, 1981). More than four decades ago, Dr. Paul Beeson argued against the routine use of indwelling urinary catheters (Saint, 2002). He argued that the decision to use the devices should be made with the knowledge that they could lead to serious consequences or disease for the patient (Saint). In addition ot increased morbidity and mortality, infections associated with the use of urinary catheters lead to increased healthcare costs and patient discomfort (Saint). In 2007, Medicare decided to disallow incremental payments associated with eight secondary conditions that it sees as preventable complications of healthcare (Rosenthal M., 2007). Catheter-associated urinary tract infection, if not present at the time of admission, will no longer be taken into account in calculating payment to hospitals after October 1, 2008 (Rosenthal). After twenty-seven years, the Centers for Disease Control will issue new draft guidelines for the prevention of CAUTI in June 2008 (Brennon, 2008). Appropriate catheter placement and avoiding inappropriate catheter days will be addressed in the new guidelines (Brennon). New guidelines will assist the infection control practitioner in mitigating patient risk for CAUTI through development of process improvements designed to decrease the number of catheter days experienced by the patient."
