Journal Article Critique : Increasing Hospital Admission Rates For Urological Complications After Transrectal Ultrasound Guided Prostate Biopsy

According to the Centers for Disease Control and Prevention [CDC] (2017), “Urinary tract infections (UTIs) are the fourth most common type of healthcare-associated infection, with an estimated 93,300 UTIs in acute care hospitals in 2011. UTIs additionally account for more than 12% of infections reported by acute care hospitals. Virtually all healthcare-associated UTIs are caused by instrumentation of the urinary tract” (p. 7-1).

Being able to identify lumps, swelling, tissue damage, cysts, and the overwhelming news of the sex of a baby all have something in common, an ultrasound. Swelling of the spleen, kidney stones, blood clots, aneurysms, cancer and so much more can be identified through the works of an ultrasound’s imaging technique. Ultrasound involves many concepts, procedures, and careers. The amount of medical possibilities involved with ultrasounds is useful in major medical diagnostics. The field of ultrasounds and career opportunities are widely growing. As medical careers flourish, needs for technicians in many fields of medicine are increasing. Instead of a doctor choosing complex and risky surgery to find out problems within the body, they can now

Prostate Cancer is a disease in which there is an uncontrolled growth of cells that lines the ducts of the prostate gland. The abnormal cells can spread throughout the prostate and nearby organs, such as the seminal vesicles. If not caught early they can spread (metastasized) to other organs of the body through the lymph or blood stream. (“...Treatment...” 13) Prostate Cancer can be like a silent killer. Some may show signs and symptoms of this disease while others may not. Some symptoms may include frequent urination, blood in the urine or semen, delayed or slowed start of urinary stream and dribbling or leakage of urine. Diagnosis testing for Prostate Cancer are digital

Dr. Fox is an emergency physician at UCI Medical Center, treating and diagnosing patients using an ultrasound. His scope of research involves looking at patients’ internal organs via ultrasound, which is much quicker and less harmful than using x-ray scans that are traditionally used in emergency departments. He is also a part of the American Institute of Ultrasound in Medicine (“Faculty and Staff”). Dr. Fox is also a director of instructional ultrasound and is the assistant dean at the UCI School of Medicine (“John Christian Fox”). He started an ultrasound rotation at the UCI School of Medicine, and with a grant given by SonoSite, Inc., the ultrasound curriculum is now embedded within the UCI School of Medicine curriculum (“Faculty and Staff”). He went to Tufts University School of Medicine, receiving his MD in 1997 (“John Christian Fox”). His main research focus is to try to incorporate ultrasound more into the emergency department, and tries to find revolutionary ways to utilize ultrasound, especially because it is very cost-efficient and images are seen real-time, unlike MRI scans or x-rays, which can emit harmful radiation or results take much longer to acquire. Eric Viquez is one of the Bio 199/EMRAP (Emergency Medicine Research Associates Program) students in Dr. Fox’s ultrasound lab. He is currently a 4th year undergraduate biological sciences major who is going to medical school in the fall; he shadows shifts with Dr. Fox and

Also another serious complication of CAUTI is BSI (Blood stream infections) that can be fatal if not caught and treated promptly. “The Clinical Performance of Quality Health Care, along with Joint Commission” offers standards and objectives for facilities to assess measure and improve their standards at the lowest cost possible. The database covers nursing care and education, along with guidelines on prevention. Moreover the JCAHO regulatory standards for catheterized patients are explained and the documentation that is expected when JCAHO inspections are rendered in a facility. The source “Stop orders to reduce inappropriate urinary catheterization in hospitalized patients” states that by following standard precautions with every patient these infections can be prevented. . Also the source explored whether catheters should be used at all in an effort to decrease the incidence of CAUTI’s. Intermittent catheterizations along with supra-pubic were explored with a decreased incidence of bacteria being present in the bladder afterwards. The source “Strategies to prevent catheter-associated urinary tract infections in acute care hospitals” offered ways of cleansing and disinfecting the skin before insertion to reduce the risk of infection. Many CAUTI’s are linked to bacteria harboring in or around the site at insertion. By using not only aseptic technique but also cleansing the skin with chlorhexadine can decrease he incidence of infection

Presented by BMJ Quality and Safety, Meddings et al (2013) sought to review interventions to reduce unnecessary catheter usage and prevent catheter-associated urinary tract infections. The review panel consisted of six individuals all listed as authors on this integrative review who utilized two

An implemented change that would reduce the rates of CAUTI’s in acute health care facilities would be evidence based nurse lead protocols. The protocols would not only benefit the hospitals but they would also contribute to patient satisfaction scores.

(2014) article “Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: An integrative review,” was published in the British Medical Journal Quality Safety. Meddings et al. (2014) conducted a systemic review and a meta-analysis in a hospital setting. Also, Meddings et al. (2014) report CAUTIs was reduced by 53%. The authors conclude UC reminders and stop orders appear to reduce UC use and CAUTIs.

Men should talk with a doctor if they are 45 and at high risk for prostate cancer. This includes those with a family history, especially African American men.

One of the authors patients of that very day was order a multitude of tests, when, one test being the ultrasound, held a better stand in imaging or screening over the others but she was asked to do all the test. An additional test, that was not necessary, added to the cost of health care for that patient. The article mentions over testing and over treatment in one way or another, cost thousands of dollars that come out of paychecks from every household each year. The excesses use of these tests and accruing cost has been looked at as financial and physically toxic in the name of health care. As a patient inquiring which test would best help bring about a conclusion to a symptom, could exclude the extra test altogether, unless the other test is acquired after all possible conclusions have been

During my research of the High, intensity focused ultrasound (HIFU) for Prostate Cancer treatment. I found these facts and information on the topic of the HIFU treatment:

This article does not provide the search strategy including a number of databases and other resources which identify key published and unpublished research. In this article, both the primary sources and the theoretical literatures are collected and appraised in order to generate the research question and to conduct knowledge-based research. In the section of the literature review, nineteen professional articles are appraised in order to provide the significance and background of the study. Saint develops the research question based on these analyses. “Catheter-associated urinary tract infections in surgical patients: A controlled study on the excess morbidity and costs” is one of the primary sources written by Givens and Wenzel who conduct and analyze this study. In addition, “Clinical and economic consequences of nosocomial catheter-related bacteriuria” is a review of a literature article which is the secondary source. Although many studies state that patient safety is a top priority and CAUTI can be controlled by the caution of health care providers, the infection rate is relatively high among other nosocomial infections. One of the reasons Saint and colleagues uncovered is unawareness and negligence by health care

The baby boomer generation has paid handsomely into social medical programs such as Medicare and Medicaid. (Pozgar, 2005) These programs are not as solvent as they were at one time since the number of recipients has outpaced the number of payers. (Pozgar, 2005) Endobronchial ultrasound provides a sound economic advantage to the Medicare and Medicaid system as well as all insurers. This is a positive attribute since historically technology has been thought to increase costs. (Sultz, 2014) According to Sultz et al (2014), “Whatever its benefits, the increased use of new technology has contributed to higher healthcare costs. Some believe, however, if new technology were used properly and not overused for the sake of preventative medicine or to take advantage of its profit potential, it would actually lower healthcare costs.” This is exactly the situation with endobronchial ultrasound! Harrison (2011) states that, “Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) could cost about $2000 less per patient than mediastinoscopy in detecting mediastinal lymphadenopathy, researchers reported here at CHEST 2011: American College of Chest Physicians Annual Meeting.” This technologically advanced, patient focused procedure fits well with the mission, vision and values of the Methodist Health

The Omega Ultrasound System would be the best choice to green light for the Healthymagination initiative. After assessing all the potential products, we determined that the lack of concrete metrics, difficulty or uncertainty in measuring outcomes, or clinical relevance to the Healthymagination goal rendered the TEEMax, UltraLipo, and HepEcho unfit for launch. We’ve outlined justification for this decision in (Figure 1.), but we believe the Omega system provides the greatest opportunity for meeting Healthymagination standards with the best chance of obtaining definitive evidence to support the certification.

Analysis of relevant physician behavior – urologists vs. generalists; doctors may refuse prescriptions and do not initiate treatment