Use Of Advanced Medical Technologies Research Articles

Estimation of the maximum potential cost saving from reducing serious adverse events in hospitalized patients.

The increasing use of advanced medical technologies to detect adverse events, for instance, artificial intelligence-assisted technologies, has shown promise in improving various aspects within health care but may also come with substantial expenses. Therefore, understanding the potential economic benefits can guide decision-making processes regarding implementation. We aimed to estimate the potential cost savings associated with reducing length of stay and avoiding readmissions within the framework of an artificial intelligence-assisted vital signs monitoring system. We used data from Danish national registries and coarsened exact matching to estimate the difference in length of stay and probability of readmission among adult in-hospital patients exposed to and not exposed to serious adverse events. We used these estimates to calculate the maximum potential savings that could be achieved by early detection of adverse events to reduce length of stay and avoid readmissions. Patients exposed to serious adverse events during admission had 2.4 (95% CI: 2.4-2.5) additional hospital bed days and had 14% (95% CI 11%-17%) higher odds of readmissions compared with patients not exposed to such events. A base case scenario yielded maximum potential savings if one patient avoided a serious adverse event of EUR 2040 due to reduced length of stay and EUR 43 due to avoidance of readmissions caused by serious adverse events. Reductions in serious adverse events are associated with decreased healthcare costs due to reduced length of stay and avoided readmissions. Artificial intelligence-assisted vital signs monitoring systems are one potential approach to reduce serious adverse events, however, the ability of this technology to reduce adverse events remains unclear. Comprehensive prospective analyses of such systems including the intervention and implementation costs are necessary to understand their full economic impact.

Optimizing ventilatory support in ARDS: A comprehensive guide for ICU nurses on patient care

The emergence of COVID-19 as a global pandemic has placed an unprecedented strain on healthcare systems worldwide, highlighting a critical shortage of trained healthcare professionals equipped to manage such a crisis. This deficit poses a significant challenge to the delivery of healthcare services, particularly in the context of intensive care units (ICUs) where the use of advanced medical technologies, such as ventilators, is paramount. For nurses with limited experience in ICU settings, navigating the complexities of invasive positive pressure ventilation (IPPV), a principal method of mechanical ventilation for critically ill patients can be daunting. This article aims to serve as a comprehensive guide for nurses less familiar with the intricacies of managing patients on IPPV, offering insights and strategies to enhance their competence and confidence in this critical aspect of patient care.

The Influence of Health Professional Ethics on Controversial Medical Decisions

This study investigates the implications of differences in ethical values between healthcare practitioners, patients, and families related to the use of advanced medical technology in medical decision making. In the context of complex medical decisions, this research reviews how moral, social, and medical factors influence the decision-making process, especially in situations of terminating care for patients in terminal condition. Through a multidisciplinary approach, this study investigates how healthcare practitioners navigate ethical dilemmas, consider patient perspectives, and integrate ethical values in clinical practice. The results of this study provide deep insight into the complex dynamics of medical decision making and encourage the adoption of a holistic approach in responding to differences in ethical values

District nurses’ experiences of advanced medical technology in home care: A qualitative interview study

The escalation in the number of medical devices in home care increases the demands on district nurses’ knowledge and skills. This qualitative interview study with 13 district nurses from Sweden aimed to describe their experiences of advanced medical technology in home care. The COREQ checklist for qualitative studies was applied. The results showed two categories: district nurses’ experiences of collaborating in teams and district nurses’ experiences of performing safe care. The safe use of advanced medical technology in home care required good collaboration between all the parties involved. This resulted in a certain amount of freedom and increased quality of life for the patients. District nurses needed time, continuity, practical training, and repeated education to be able to provide safe care. Distinct leadership was important at all organizational levels. The results can generate a safe and sustainable work environment for district nurses, almost independent of their technical background.

Explaining the adoption and use of computed tomography and magnetic resonance image technologies in public hospitals

ObjectiveThis article examines what the adoption and use of advanced medical technologies – computed tomography (CT) and magnetic resonance imaging (MRI) – by public hospitals depend on and to what extent.MethodsFrom a sample of panel data for all public hospitals in the health service of Galicia (a subregion of the Galicia-North of Portugal Euroregion) for the 2010–2017 period, we grouped explanatory variables into inputs (resources), outputs (activities) and socio-demographic variables. Factor analysis was used to reduce as much as possible the number of analysed variables, discriminant analysis to examine the technologies adoption decision, and multiple regression analysis to investigate their use.ResultsFactor analysis identified motivators on adoption and use of CT and MRI medical technologies as follows: hospital inputs/outputs (Factor 1); radiology studies and adoption of CT by public hospitals (Factor 2); research/teaching role and big-ticket diagnostic and therapeutic (lithotripsy) technologies (Factor 3); number of transplants (Factor 4); cancer diagnosis/treatment (Factor 5); and catchment area geographical dispersion (Factor 6). Cronbach’s alpha of 0.881 indicated an acceptable degree of reliability of the factor variables. Regarding adoption of these technologies, Factor 1 is the most influential, explaining 37% of the variance and showing adequate global internal consistency, whereas Factor 2 is limited to 13% of the variance. In the discriminant analysis, values for Box’s M test and canonical correlations such as Wilks’s lambda for the two technologies underpin the reliability and predictive capacity of the discriminant equations. Finally, and according to the regression analysis, the factor with the greatest influence on CT and MRI use is Factor 2, followed by Factors 1 and 3 in the case of CT use, and Factors 3 and 5 in the case of MRI use.ConclusionCT and MRI adoption by public hospitals is mainly determined by hospital inputs and outputs. However, the use of both medical technologies is mainly influenced by conventional radiology studies and CT adoption. These results suggest that both choices – adoption and use of advanced medical technology – may be separate decisions as they are taken possibly by different people (the former by managers and policymakers and the latter by physicians).

Education and training of nurses in the use of advanced medical technologies in home care related to patient safety: A cross-sectional survey

BackgroundTo use advanced medical technologies (AMTs) correctly and safely requires both specialist knowledge and skills, and an awareness of risks and how those can be minimized. Reporting safety concerns about AMTs in home care can contribute to an improved quality of care. The extent to which a health care organization has integrated the reporting, evaluation and learning from incidents is a key element of that organization's patient safety culture. ObjectivesTo explore nurses' experiences regarding the education followed in the use of AMTs in the home setting, and their organizations' systems of reporting. DesignDescriptive cross-sectional design. Methods209 home care nurses from across the Netherlands who worked with infusion therapy, parenteral nutrition and/or morphine pumps responded to the online questionnaire between July 2018 and February 2019. The analysis of the data was mainly descriptive. ResultsEducational interventions that are most often used to learn how to use AMTs were, as an average over the three AMTs, instruction by a nurse (71%), practical training in the required skills (71%) and acquiring information to increase theoretical knowledge (69%). Considerable attention is paid to patient safety (88%) and the home setting (89%). However, a substantial proportion of the nurses (up to 29%) use AMTs even though they had not been tested on their skills. 95% of the respondents were well acquainted with the incident reporting protocol of their organization, but only 49% received structural or regular feedback on any actions taken as a result of event reporting. ConclusionsThis study revealed aspects of nurses' education that imply risk factors for patient safety. Practical training is not always given, additional or retraining is often voluntary, and the required skills are not always tested. However, the results show that nurses do have a good awareness of patient safety. Incidents are mainly discussed within the team, but less at the organizational level.

Reporting incidents involving the use of advanced medical technologies by nurses in home care: a cross-sectional survey and an analysis of registration data

BackgroundAdvanced medical technologies (AMTs), such as respiratory support or suction devices, are increasingly used in home settings and incidents may well result in patient harm. Information about risks and incidents...

The use of advanced medical technologies at home: a systematic review of the literature

BackgroundThe number of medical technologies used in home settings has increased substantially over the last 10–15 years. In order to manage their use and to guarantee quality and safety, data on usage trends and practical experiences are important. This paper presents a literature review on types, trends and experiences with the use of advanced medical technologies at home.MethodsThe study focused on advanced medical technologies that are part of the technical nursing process and ‘hands on’ processes by nurses, excluding information technology such as domotica. The systematic review of literature was performed by searching the databases MEDLINE, Scopus and Cinahl. We included papers from 2000 to 2015 and selected articles containing empirical material.ResultsThe review identified 87 relevant articles, 62% was published in the period 2011–2015. Of the included studies, 45% considered devices for respiratory support, 39% devices for dialysis and 29% devices for oxygen therapy. Most research has been conducted on the topic ‘user experiences’ (36%), mainly regarding patients or informal caregivers. Results show that nurses have a key role in supporting patients and family caregivers in the process of homecare with advanced medical technologies and in providing information for, and as a member of multi-disciplinary teams. However, relatively low numbers of articles were found studying nurses perspective.ConclusionsResearch on medical technologies used at home has increased considerably until 2015. Much is already known on topics, such as user experiences; safety, risks, incidents and complications; and design and technological development. We also identified a lack of research exploring the views of nurses with regard to medical technologies for homecare, such as user experiences of nurses with different technologies, training, instruction and education of nurses and human factors by nurses in risk management and patient safety.

Swine used in the medical university: overview of 20 years of experience.

Center for Development of Advanced Medical Technology (CDAMTec) in Jichi Medical University was established in 2009. It is the first educational research facility specialized for medical research and training using swine in Japan. Preclinical studies on large animals are essential prior to clinical trials to develop regenerative medical products and medical equipment. We have continued comprehensively considering using miniature swine for experiments to develop advanced medical technologies and train physicians with advanced clinical abilities, while paying attention to animal welfare. The center plays a pioneering role in this field by accumulating know-how such as (1) Construction and effective utilization of research facilities, (2) Procurement of quality animal resources, (3) Education and training of technical staff, (4) Establishment of support system for physicians and researchers. We now open up widely these expertise and foundation for medical research and training not only within our university but also outside the university, so as to move faster to practical use of advanced medical technology and contribute to human health and welfare.

Health–illness transition among persons using advanced medical technology at home

This study aimed to elucidate meanings of health-illness transition experiences among adult persons using advanced medical technology at home. As an increasing number of persons perform self-care while using different sorts of advanced medical technology at home, knowledge about health-illness transition experiences in this situation may be useful to caregivers in supporting these patients. A qualitative design was used. Five women and five men, all of whom performed self-care at home, either using long-term oxygen therapy from a ventilator or oxygen cylinder, or performing peritoneal or haemodialysis, were interviewed. Ethics committee approval was obtained. Informed consent was received from all participants, and ethical issues concerning their rights in research were raised. The interviews were analysed using a phenomenological hermeneutical methodology, including both an inductive and a deductive structural analysis. This method offers possibilities to obtain an increased understanding by uncovering a deeper meaning of lived experiences through interviews transcribed as texts. The health-illness transition for adult persons in this context was found to mean a learning process of accepting, managing, adjusting and improving daily life with technology, facilitated by realizing the gain from technology at home. Further, the meaning of the health-illness transition experience was interpreted as contentment with being part of the active and conscious process towards transcending into a new state of living, in which the individual and the technology were in tune. The healthy transition experience was characterized by human growth and becoming. This study elucidates one meaning of health-illness transition experiences in relation to the use of advanced medical technology on a more generic level, independent of the specific type of technology used. A positive attitude towards technology at home facilitates the transition.

Kostnader ved behandling av svært for tidlig fødte barn

The cost of treating premature infants is increasing due to use of advanced medical technology and rising labour costs. Few Norwegian studies have been published in the field. This study has assessed treatment costs for very-low-birth-weight infants in St. Olavs University Hospital. Children born in 1997 or 2007 were studied retrospectively. Individual costs (diagnostics and treatment) were estimated from detailed analysis of each patient's daily medical record. General daily costs (salary, equipment etc.) for treatment levels 1 (growth and development), 2 (observation) and 3 (intensive treatment) were estimated from department and hospital budgets. The total mean treatment cost from admission to discharge was 603,238 NOK per patient in 2007, an increase from 475,131 NOK in 1997. As more infants survived without serious complications in 2007, the cost of a surviving healthy infant was actually lower in 2007 (922,599 NOK) than in 1997 (1,135,035 NOK). DRG reimbursements cover the cost for treating children with a birth weight in the range 1000 - 1499 g, but not for those weighing < 1000 g. Very-low-birth-weight infants are probably the most expensive patient group treated in hospitals; the total cost in 2007 was (mean) 900,000 NOK.

Ethical and legal aspects of stem cell practices in Turkey: where are we?

Advances in medical technology and information have facilitated clinical practices that favourably affect the success rates of treatment for diseases. Regenerative medicine has been the focus of the recent medical...

The role of cardiovascular imaging techniques in the assessment of patients with acute chest pain

Chest pain is the most common presenting symptom of coronary artery disease. The assessment and appropriate management of patients with acute chest pain and non-diagnostic electrocardiograms (ECGs) remain a continuing clinical problem, with major logistic and financial implications for health-care providers. Cardiovascular imaging is at the forefront of health care, experiencing rapid changes over the recent years, particularly with the use of advanced medical technologies. Imaging techniques like acute rest myocardial perfusion imaging (MPI), echocardiography, electron beam computed tomography (CT), cardiac magnetic resonance imaging (MRI) and multi-detector CT (MDCT) have been used recently in the evaluation and triage of patients with chest pain in addition to the conventional investigations such as ECGs and cardiac biomarkers in the chest pain units. The annual potential cost savings, by incorporating the routine use of acute rest MPI in patients with low-to-moderate risk and non-diagnostic ECGs are substantial. The high negative predictive value of a normal resting MPI in patients with chest pain for myocardial infarction and future cardiac events is well established. Echocardiography is also considered to be useful but the technique is operator dependent and at present there is insufficient data to support its use. Cardiac MRI is expensive and time consuming and there is insufficient diagnostic and prognostic data to make it suitable for chest pain patients at present. There has been increasing interest in MDCT recently, especially with the advent of 64-slice CT but the sensitivity and specificity in chest pain patients are no better than MPI so far.

Parental perception of neonatal intensive care in public sector hospitals in South Africa.

Little is known about parental experience and decision making with regard to premature infants requiring intensive care in developing countries. We undertook this study to characterise parents' experience of physician counselling and their role in making life-support decisions for very low-birth-weight (VLBW) (birth weight < 1 501 g) infants born in South Africa's public-sector neonatal intensive care units (NICUs). Parents of surviving VLBW infants treated in three Johannesburg-area public hospitals and attending follow-up clinics in August 2001 were interviewed regarding their experience of perinatal counselling on outcomes (pain, survival, disability), perception of actual and optimal decision making, and satisfaction with NICU communication. Parents of 51 infants were interviewed. Seventy-five per cent of parents reported antenatal counselling by physicians on at least one perinatal topic (severe disability, pain, death, finances or religious/moral considerations). The majority of parents (> 60%) who received counselling thought that these topics had been discussed adequately. Most parents reported that doctors had the primary decision-making role, either without consulting them (41%) or after consulting them (37%). Joint decision making was rare (14%). Parents wanted more input in life-support decisions than they reported being given. Counselling is not consistently provided in public-sector hospitals in Johannesburg. Parents of premature infants want a larger share in NICU decision making than they currently experience. Most parents were satisfied with communication later during their infant's hospitalisation. South Africa presents a unique opportunity to study the use of advanced medical technologies in a nation with marked disparities in access to care.

Resuscitation Technology in the Emergency Department: Towards a Dignified Death

Social scientists and ethicists often blame the increased use of advanced medical technologies for the undignified character of contemporary dying. Based on ethnographic material and in‐depth interviews with health‐care providers, I analyse how resuscitation technology shapes sudden death in emergency departments. First, I examine the extent to which the course of resuscitative efforts is a consequence of technological factors or of health care system characteristics. Second, I look at how resuscitation technologies indirectly offer an opportunity to face pending death. In the last part, I investigate how this opportunity can be fostered when the emergency department staff takes the needs of relatives and friends into consideration.

Advanced medical technology: The ethical implications for social work practice with the dying

Abstract This article will address the complexity of ethical issues generated by the availability and use of advanced medical technology with those who are terminally ill. It will explore the impact of such technologies on the patient and the family, and pay particular attention to the consequences for the social worker in health care. Through the use of case studies, the article will illustrate the critical issues surrounding such ethical dilemmas as experienced by the social worker. It will clarify the role and function of social workers who will be faced with these types of ethical dilemmas in their practice with those who are dying.

Ethical Aspects of Pediatric Home Care

This essay is a discussion of ethical issues that arise in the provision of home health care to technology-dependent children. Different ethical norms, especially with regard to the degree of professional responsibility for outcomes, traditionally have applied to home care and hospital care. In particular, parents generally are expected to do their best, but are not expected to have the same specialized knowledge of risks and benefits with regard to particular interventions as health professionals. When home health care involves the use of advanced medical technology, it strains traditional conceptions of parental responsibilities to care for the health of their children at home. It can also strain traditional concepts of professional responsibilities to care for critically ill children in hospitals. We discuss some of the tensions that arise as medical, psychological, and economic forces lead to the increasing use of high technology in the care of children outside of traditional health care institutions.