Management in hospitals

These patients may also exhibit symptoms of excessive stimulation of muscarinic receptors (abdominal cramps, diarrhea, increased salivation, excessive bronchial secretions, miosis, bradycardia). Small doses of edrophonium (1-2 mg intravenously) will produce no relief or even worsen weakness if the patient is receiving excessive cholinesterase inhibitor therapy. On the other hand, if the patient improves with edrophonium, an increase in cholinesterase inhibitor dosage may be indicated. Clinical situations in which severe myasthenia (myasthenic crisis) must be distinguished from excessive drug therapy (cholinergic crisis) usually occur in very ill myasthenic patients and must be managed in hospital with adequate emergency support systems (eg, mechanical ventilators) available. 

Godwin HN, Sanborn MD. 1995. Total quality management in hospital pharmacy. Am Pharm NS35 51. 

Kandampully, J., Mok, C. and Sparks, B. (2001) Service Quality Management in Hospitality, Tourism, and Leisure. London Haworth Press. 

More accurate measurement of incidence through minimizing referral bias individuals who are not managed in hospital are included, particularly elderly, those with mild condition and fatal events occurring outside hospital... 

Botz, C. K. (1983), Technology resource management in hospitals A new opportunity, presented at the AAMI 18th Annual Meeting., Dallas, Texas. 

For instance, Jin et al. (2009) provide the application of urban policy making and Lane Husemann (2008) the exploration of health care management in hospitals by deploying system dynamics. 

Despite the growing emphasis on pain management, pain often remains undertreated and continues to be a problem in hospitals, long-term care facilities, and the community. In one series of reports, 50% of seriously ill hospitalized patients reported pain however, 15% were dissatisfied with pain control, and some remained in pain after hospitalization.14,15... 

During the initial evaluation, providing for the safety of the patient is of paramount importance. The severity of intoxication and potential for withdrawal must be quickly and accurately determined. Extreme alcohol intoxication can be fatal either by the production of cardiac arrhythmias, aspiration (the inhalation of stomach contents that are vomited), or other causes. We have all seen reports of college students dying from alcohol poisoning. Likewise, up to 10% of patients in severe alcohol withdrawal can die without treatment. Fortunately, most patients do not experience the most severe forms of alcohol withdrawal such as the DTs. Mild withdrawal can be managed in the outpatient setting with appropriate support and patient adherence, but severe withdrawal requires an inpatient hospitalization. See Section 6.5 for further discussion of the initial evaluation. 

First and foremost, proper management of hospital effluent should take into consideration the characteristics of both the hospital structure and its catchment area. In case of a new healthcare structure, the main aspects to consider when devising its wastewater management strategy are ... 

Verlicchi P, Galletti A, Masotti L (2010) Management of hospital wastewaters the case of the effluent of a large hospital situated in a small town. Water Sci Technol 61 2507-2519... 

Verlicchi P, Galletti A, Al Aukidy M (2011) Best practices in the management of hospital effluents. Proc. VI EWRA International Symposium Water Engineering and Management in a Changing Environment, Catania, Italy... 

The new GCP requires clinical study sites to have enough facilities to conduct clinical trials and be able to cope in the case of emergency. Adequately trained staff should be available. The sites must prepare SOPs for accepting, reviewing and operating clinical trial. Additional SOPs are required for the operation of the Institutional Review Board (IRB). A clinical trial office and an office for IRB operation must be established in the study site. These requirements have been defined as the minimum requirements for any clinical trial to be conducted in hospitals equipped with ample resources, to manage many SOPs, and office staff for clinical trial and IRB. 

Berlin RM. Management of insomnia in hospitalized patients. Ann intern Mea 1984 100 398-404. 

Accidents, such as that in Bhopal or the explosion of an ammonia lorry in Dakar, involve a very large number of casualties. The time to set up the emergency services and the complexity of a 15-min rinse with water require the use of active solutions to reduce the time to action and expect a sufficient reliable effect by stopping the action of the chemical, pending possible management in suitable hospital facilities. 

Lien LF, Angelyn Bethel M, Feinglos MN. In-hospital management of type 2 diabetes mellitus. Medical Clinics of North America 2004, 88, 1085-1105. 

Breen L, Crawford H. 2005. Improving the pharmaceutical supply chain Assessing the reality of e-quality through e-commerce application in hospital pharmacy. Int J Qual Reliab Manag 22 572. 

---