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1.
JPGN Rep ; 4(3): e335, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37600618

RESUMEN

Intractable pruritus is one of the most prominent and debilitating features of Alagille syndrome. Maralixibat is the first US Food and Drug Administration-approved drug for the treatment of cholestatic pruritus in children with Alagille syndrome aged 3 months and older. Clinical trials of maralixibat have reported follow-up to 4 years and reported a ≥1-pt reduction using the Itch-Reported Outcome (Observer) (ItchRO[Obs]) instrument (0-4 scale), as this decrease was previously defined as a clinically meaningful improvement in pruritus; participants in clinical trials were expected to be maintained on stable doses of antipruritic agents. We report on a patient with 3 notable features: (1) complete resolution of her pruritus; (2) durability of this response for over 7 years; and (3) ability to discontinue all other antipruritic medications.

2.
HERD ; 16(2): 24-37, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36691318

RESUMEN

OBJECTIVES: Evaluate the relationship between nurses' perception of the long-term care (LTC) environment, specifically having visible and accessible hand hygiene stations (HHS), and nurses' fatigue during the COVID-19 pandemic. BACKGROUND: LTC nurses experience not only heavy workloads and fatigue but also a high risk of infection during the COVID-19 pandemic. Few studies have evaluated the relationship between safety measures such as having visible and accessible HHS and nurses' fatigue. METHODS: The cross-sectional COVID-19 Impact on Nurses Study (COINS) was an online survey distributed to members of the American Association of Post-Acute Care Nursing through the REDCap survey platform, between June 1, 2020, and January 31, 2021. Logistic regression modeling was conducted to identify the relationship between nurses' perception of having visible and accessible HHS and fatigue among LTC nurses. RESULTS: The majority of LTC nurse respondents (78.35%) reported having moderate to very severe fatigue. Nurses who reported not having enough visible and accessible HHS in their work environment have statistically significantly higher odds (odds ratio [OR] = 0.37, 95% confidence interval [CI] [0.20, 0.70], p = .002) of reporting experiencing moderate to very severe fatigue compared to nurses who perceived there was adequate HHS. The logistic regression is significant while controlling for sociodemographic differences, guilt for family and patients, support from work, and confidence in the future of LTC. CONCLUSIONS: This study reveals the LTC environment that incorporates better considerations of more visible and accessible HHS might mitigate nurses' fatigue during the pandemic. A conceptual framework has been proposed for future studies.


Asunto(s)
COVID-19 , Higiene de las Manos , Enfermeras y Enfermeros , Humanos , COVID-19/epidemiología , Cuidados a Largo Plazo , Pandemias , Estudios Transversales , Fatiga/epidemiología , Encuestas y Cuestionarios
3.
Nurse Lead ; 20(6): 594-600, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35464634

RESUMEN

The COVID-19 pandemic created stressful working conditions for nurses and challenges for leaders. A survey was conducted among 399 acute and ambulatory care nurses measuring availability of calming and safety resources, perceptions of support from work, and intent to stay. Most nurses reported intent to stay with their employer, despite inadequate safety and calming resources. High levels of support from work were significantly influenced nurses' intent to stay. Leadership actions at the study site to provide support are described, providing context for results. Nurse leaders can positively influence intent to stay through consistent implementation of supportive measures.

4.
Med Sci Educ ; 31(2): 495-502, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34457907

RESUMEN

BACKGROUND: Limited English proficiency patients experience high rates of medical errors and receive lower quality of care. To better prepare the healthcare workforce, Latino Medical Student Association (LMSA) members at Oregon Health & Science University (OHSU) developed an Introductory Medical Spanish course to complement an 18-month pre-clinical curriculum. METHODS: This 10-week elective course consisted of 2 h of weekly instruction, two Cafecito cultural sessions, and one clinical standardized assessment (CSA). The authors used Bloom's taxonomy as a theoretical framework to design course components. Pre- and post-course surveys captured comfort scores with performing a history and physical (H&P) and building rapport in Spanish. Change in comfort was analyzed via paired T-test in STATA. The authors performed a content analysis of CSA feedback and a thematic analysis of Cafecito reflections. RESULTS: Fifteen preclinical medical students in cohort 1 and sixteen in cohort 2 completed the 10-week course. Comfort scores significantly (p < 0.05) increased by 2.87 and 1 point(s) for cohorts 1 and 2, respectively. There were differences between cohorts 1 and 2, including self-reported language fluency (93% vs 47% "beginner" level) and value of the cultural sessions (73% vs 50%), respectively. Qualitative content analysis of CSA feedback and thematic analysis of Cafecito reflections revealed students successfully applied learned material to a new case and developed a newfound appreciation for Latinx public health issues. CONCLUSIONS: This course effectively increased students' comfort using medical Spanish which successfully translated into simulated patient environments. It also provided a space to discuss nuances of health and Latinx cultures with peers. Ultimately, this course's feasible, effective structure can serve as a model to complement condensed pre-clinical undergraduate medical education (UME) curricula.

5.
MedEdPublish (2016) ; 10: 22, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-38486559

RESUMEN

This article was migrated. The article was marked as recommended. Background & Objectives: Workplace-based assessments (WBAs) are a vital aspect of medical student competency assessment for the core Entrustable Professional Activities (EPAs), but pose significant challenges since assessment must occur in real-time during the routine care of patients. We developed an online WBA system designed to overcome these challenges, and implemented it across an entire undergraduate medical education program to address the need for EPA competency assessment. We describe the development and implementation process, and present initial results from our inaugural medical student cohort. Methods: The WBA tool was designed to be student-driven, easy to use, and minimally disruptive to clinical care. Students trigger assessments by choosing the desired EPA to be assessed within a custom-built Qualtrics XM survey application. Their clinical assessor is prompted to select their level of involvement in the activity using the modified Ottawa co-activity scale and provide brief written feedback. Direct verbal feedback at time of discussion is encouraged. Results: 3,568 WBAs were completed. The mean number of assessments per student for all EPAs combined was 24.27 with a range of 1-103. All students completed at least one WBA. Over the course of 12 months, the mean number of EPAs recorded per student in this cohort was lowest for EPA 10 (Recognizing a Patient Requiring Urgent or Emergent Care and Initiate Evaluation and Management) (mean=0.36; range 0-4; n=53) and was highest for EPA 6 (Provide an Oral Presentation for a Clinical Encounter) (mean=5.46; range 1-17; n=803). The mean number of minutes it took to complete the assessments was 2.7 minutes with a standard deviation of 1.2 minutes (n=2,803). Conclusion: An electronic application-based survey collecting real-time WBAs to assess progress toward attaining competence in EPA performance resulted in increased assessment data within a medical school cohort.

6.
Adv Exp Med Biol ; 1268: 143-154, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32918217

RESUMEN

Solar UV exposure is critical and complex in the etiology and prognosis of skin cancer, particularly cutaneous malignant melanoma. Sun exposure and one of its "derivatives," vitamin D, have been implicated in protection against mortality from melanoma. However, the relationships are inconsistent. At this time, it is not possible to make clear recommendations for or against sun exposure in relationship to melanoma prognosis. However, this relationship deserves continued exploration.


Asunto(s)
Neoplasias Cutáneas/mortalidad , Rayos Ultravioleta , Humanos , Melanoma/etiología , Melanoma/mortalidad , Melanoma/prevención & control , Neoplasias Inducidas por Radiación/etiología , Neoplasias Inducidas por Radiación/mortalidad , Neoplasias Inducidas por Radiación/prevención & control , Pronóstico , Neoplasias Cutáneas/etiología , Neoplasias Cutáneas/prevención & control , Rayos Ultravioleta/efectos adversos , Vitamina D
7.
Clin Obstet Gynecol ; 62(4): 712-726, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31259839

RESUMEN

Evaluation and management of abnormal uterine bleeding (AUB) are possible in the office. Approaching AUB evaluation from an etiology-based perspective allows the gynecologist to focus evaluation efforts on the most probable causes of AUB for a particular patient and therefore customize the management accordingly. Developing skills with imaging such as transvaginal ultrasound, saline infusion sonography, and diagnostic hysteroscopy are important for AUB etiology diagnosis. Operative hysteroscopy experience can be developed for AUB management in the office and endometrial ablation provides a minimally invasive solution for some patients.


Asunto(s)
Atención Ambulatoria/métodos , Hemorragia Uterina/diagnóstico , Hemorragia Uterina/terapia , Técnicas de Ablación Endometrial/métodos , Femenino , Humanos , Histeroscopía/métodos , Ultrasonografía/métodos , Vagina/diagnóstico por imagen
8.
AMIA Annu Symp Proc ; 2019: 883-892, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-32308885

RESUMEN

Modeling variance in patient outcomes using medical claims and other forms of aggregated administrative data may ignore significant contributions associated with providers who are not recorded in billing transactions. We examined the association between interdisciplinary provider factors and length of stay (LOS) for 1,099 lumbar spine surgery patients. Interdisciplinary provider "dose" (number of providers/case), "workload" (care of other patients), and "activity" factors were defined and generated. Hierarchical Regression models were used to test the impact of these provider factors controlling for the effect of socio-demographic and clinical factors. Interdisciplinary provider factors explained 12% of additional variance in LOS. EHR-based interdisciplinary care team representations hold promise in contributing to our understanding of health care delivery and quality. Keywords: interdisciplinary care, nursing documentation, workload, length of stay, electronic health records (EHR).


Asunto(s)
Registros Electrónicos de Salud , Tiempo de Internación , Grupo de Atención al Paciente , Análisis y Desempeño de Tareas , Anciano , Femenino , Administración Hospitalaria , Hospitalización , Humanos , Vértebras Lumbares/cirugía , Masculino , Persona de Mediana Edad , Registros de Enfermería , Procedimientos Ortopédicos , Atención al Paciente , Personal de Hospital , Estudios Retrospectivos , Carga de Trabajo
9.
Stud Health Technol Inform ; 250: 261-263, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29857456

RESUMEN

Value is defined as outcomes/cost of care [1]. Although nurses contribute significantly within the interdisciplinary care team, we struggle to measure the value of nursing care or the added value of each nurse caring for a patient. This presentation reveals findings of the Nursing Value Workgroup (Workgroup), a multi-year component of the Big Data and Nursing Knowledge Initiative [2]. Panelists will discuss: Construction of a common model to provide a basis for developing nursing business intelligence and analytics; development and publication of definitions and metrics for nursing value; creation of user stories to measure nurse sensitive phenomena; and establishment of a data warehouse to facilitate research. Initial findings from a multi-hospital study on pain management and value of care will be presented.


Asunto(s)
Modelos de Enfermería , Atención de Enfermería/normas , Empatía , Humanos , Evaluación de Resultado en la Atención de Salud
10.
Clin Pediatr (Phila) ; 57(9): 1058-1063, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29192504

RESUMEN

Fecal calprotectin (FC) is a marker of intestinal inflammation. Data are limited on utility of routine FC testing in pediatric primary care. Participants 0 to 18 years old who had an FC test in the years 2010-2014 were retrospectively identified. Those with less than a year of follow-up or a prior diagnosis of inflammatory bowel disease (IBD) were excluded. In all, 84% (689/822) had normal FC; no participant with normal FC was diagnosed with IBD in the subsequent 12 months. Also, 16% (133/822) had elevated FC, and 31% of those (42/133) were diagnosed with IBD. FC values for IBD and non-IBD groups were 1084 µg/g (interquartile range [IQR] = 514.4-2000) and 27.05 µg/g (IQR = 15.6-62.6; P < .001), respectively. Abdominal pain was the primary indication. In this cohort, sensitivity of FC for IBD is 100%, and specificity is 88%. The FC test can be an excellent tool in the primary care setting to exclude IBD and avoid unnecessary referrals and colonoscopies.


Asunto(s)
Colitis Ulcerosa/diagnóstico , Enfermedad de Crohn/diagnóstico , Heces/química , Enfermedades Gastrointestinales/diagnóstico , Complejo de Antígeno L1 de Leucocito/análisis , Adolescente , Factores de Edad , Biomarcadores/análisis , Niño , Preescolar , Enfermedad Crónica , Estudios de Cohortes , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Pediatría/métodos , Atención Primaria de Salud/métodos , Estudios Retrospectivos , Medición de Riesgo , Sensibilidad y Especificidad , Factores Sexuales
11.
J Nurs Adm ; 47(10): 476-483, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28858955

RESUMEN

OBJECTIVE: This study was designed to describe variable acuity among 1 population of acute care patients. BACKGROUND: Acuity, defined as the individual patient need for nursing care, can inform level of care, nurse staffing, and the nurse-to-patient assignment. Nurse-generated data in the electronic health record can be mined and analyzed for decision support. METHODS: This study used a descriptive, retrospective analysis of repeated measures of acuity generated from 28 739 nursing assessments of 405 consecutive subjects treated for heart failure (HF) in a 455-bed southern hospital. RESULTS: Patients treated for HF have variable care needs throughout the course of treatment. Univariate analysis of variance and post hoc analysis found that gender, age, type of unit, and length of stay (LOS) had a significant impact on acuity, P < .01, with a very small effect of less than 1%, indicating that acuity should be measured instead of assumed. Patients in medical-surgical and step-down units had highly variable acuity, ranging from ready to discharge to acuity levels consistent with critical care. Across the LOS, the mean acuity stabilized at 12 hours after admission, decreased until 88 hours, then increased steadily through discharge. CONCLUSIONS: Understanding the variability in acuity within an individual patient, or a specific patient population, will contribute to decision support levels of patient care, staffing, nurse-patient assignments, and the cost of care. Frequent, sequential, and real-time measures of acuity may be valuable for tracking patient progress or measuring response to nursing interventions.


Asunto(s)
Tiempo de Internación/estadística & datos numéricos , Relaciones Enfermero-Paciente , Personal de Enfermería en Hospital/organización & administración , Gravedad del Paciente , Admisión y Programación de Personal/estadística & datos numéricos , Cuidados Críticos/organización & administración , Femenino , Humanos , Masculino , Evaluación de Resultado en la Atención de Salud , Estudios Retrospectivos
12.
Cell Physiol Biochem ; 38(4): 1532-43, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27050729

RESUMEN

BACKGROUND/AIMS: Expression of the transcriptional co-regulator tis7 is markedly increased in the adaptive small intestine in a mouse model of short bowel syndrome. Transgenic mice with enterocytic overexpression of tis7 (tis7tg) have accelerated triglyceride absorption, with increased adiposity yet reduced skeletal muscle mass. To further explore this phenotype, we examined whether tis7 also regulates amino acid and carbohydrate absorption. METHODS: Small intestinal glucose and amino acid uptake were quantified in wild type (WT) and tis7tg mice. Amino acid transporter expression was assessed by qRT-PCR and immunoblot. Apical cell surface transporter expression was quantified by cell surface biotinylation. RESULTS: Active glucose uptake rates were unchanged. Uptake of proline but not leucine was significantly reduced in tis7tg vs. WT jejunum. Expression of serum and glucocorticoid-induced kinase 1 (SGK1), a solute carrier activator, was inhibited in tis7tg jejunum. Apical membrane expression of the proline transporter SLC6A20 was reduced in tis7tg jejunum. CONCLUSIONS: Tis7 overexpression in enterocytes inhibits proline uptake, associated with decreased expression of activated SGK1 and reduced cell surface expression of SLC6A20. Consistent with the observed tis7tg phenotype, tis7 overexpression increases triglyceride absorption but has adverse effects on the uptake of selected amino acids. Tis7 has pleiotropic effects on nutrient absorption.


Asunto(s)
Proteínas Inmediatas-Precoces/metabolismo , Yeyuno/metabolismo , Proteínas de la Membrana/metabolismo , Prolina/metabolismo , Proteínas Serina-Treonina Quinasas/metabolismo , Sistemas de Transporte de Aminoácidos/genética , Sistemas de Transporte de Aminoácidos/metabolismo , Animales , Western Blotting , Peso Corporal , Dieta Alta en Grasa , Glucosa/metabolismo , Proteínas Inmediatas-Precoces/sangre , Proteínas Inmediatas-Precoces/genética , Proteínas de la Membrana/genética , Ratones , Ratones Transgénicos , Fosforilación , Proteínas Serina-Treonina Quinasas/sangre , Proteínas Serina-Treonina Quinasas/genética , ARN Mensajero/metabolismo , Reacción en Cadena en Tiempo Real de la Polimerasa
13.
Nurs Adm Q ; 39(4): 297-303, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26340240

RESUMEN

Nurse leaders and researchers are challenged by the need for sharable and comparable data on the nursing workforce and the processes of patient care. This is significant, as nursing is the largest health care workforce, with significant operational costs. The Nursing Management Minimum Data Set provides a core set of data elements to compare nursing practice across time, diverse health care settings, and geographical areas. Nursing leaders from practice, association, academic, consulting, and industry settings were interviewed to provide perspectives on how the use of standardized data sets can be useful for the profession.


Asunto(s)
Sistemas de Apoyo a Decisiones Administrativas/estadística & datos numéricos , Enfermeras Administradoras , Atención de Enfermería/organización & administración , Grupos Focales , Humanos , Relaciones Interprofesionales , Minnesota , Modelos Teóricos , Investigación en Administración de Enfermería
14.
Nurs Econ ; 32(3 Suppl): 3-35, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25144948

RESUMEN

The Patient Protection and Affordable Care Act (PPACA, 2010) and the Institute of Medicine's (IOM, 2011) Future of Nursing report have prompted changes in the U.S. health care system. This has also stimulated a new direction of thinking for the profession of nursing. New payment and priority structures, where value is placed ahead of volume in care, will start to define our health system in new and unknown ways for years. One thing we all know for sure: we cannot afford the same inefficient models and systems of care of yesterday any longer. The Data-Driven Model for Excellence in Staffing was created as the organizing framework to lead the development of best practices for nurse staffing across the continuum through research and innovation. Regardless of the setting, nurses must integrate multiple concepts with the value of professional nursing to create new care and staffing models. Traditional models demonstrate that nurses are a commodity. If the profession is to make any significant changes in nurse staffing, it is through the articulation of the value of our professional practice within the overall health care environment. This position paper is organized around the concepts from the Data-Driven Model for Excellence in Staffing. The main concepts are: Core Concept 1: Users and Patients of Health Care, Core Concept 2: Providers of Health Care, Core Concept 3: Environment of Care, Core Concept 4: Delivery of Care, Core Concept 5: Quality, Safety, and Outcomes of Care. This position paper provides a comprehensive view of those concepts and components, why those concepts and components are important in this new era of nurse staffing, and a 3-year challenge that will push the nursing profession forward in all settings across the care continuum. There are decades of research supporting various changes to nurse staffing. Yet little has been done to move that research into practice and operations. While the primary goal of this position paper is to generate research and innovative thinking about nurse staffing across all health care settings, a second goal is to stimulate additional publications. This includes a goal of at least 20 articles in Nursing Economic$ on best practices in staffing and care models from across the continuum over the next 3 years.


Asunto(s)
Modelos Organizacionales , Admisión y Programación de Personal/organización & administración , Personal de Enfermería en Hospital/provisión & distribución , Patient Protection and Affordable Care Act , Admisión y Programación de Personal/normas , Calidad de la Atención de Salud , Estados Unidos
15.
Am J Physiol Gastrointest Liver Physiol ; 307(6): G642-54, 2014 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-25059825

RESUMEN

Effective therapies are limited for patients with parenteral nutrition-dependent short bowel syndrome. We previously showed that intestinal expression of the transcriptional coregulator tetradecanoyl phorbol acetate-induced sequence 7 (tis7) is markedly increased during the adaptive response following massive small bowel resection and tis7 plays a role in normal gut lipid metabolism. Here, we further explore the functional implications of tis7 deletion in intestinal lipid metabolism and the adaptive response following small bowel resection. Intestinal tis7 transgenic (tis7(tg)), tis7(-/-), and wild-type (WT) littermates were subjected to 50% small bowel resection. Mice were fed a control or a high-saturated-fat (42% energy) diet for 21 days. Survival, body weight recovery, lipid absorption, mucosal lipid analysis, and the morphometric adaptive response were analyzed. Quantitative real-time PCR was performed to identify tis7 downstream gene targets. Postresection survival was markedly reduced in high-fat, but not control, diet-fed tis7(-/-) mice. Decreased survival was associated with anastomotic inflammation and intestinal obstruction postresection. High-fat, but not control, diet-fed tis7(-/-) mice had increased intestinal IL-6 expression. Intestinal lipid trafficking was altered in tis7(-/-) compared with WT mice postresection. In contrast, high-fat diet-fed tis7(tg) mice had improved survival postresection compared with WT littermates. High-fat diet feeding in the setting of tis7 deletion resulted in postresection anastomotic inflammation and small bowel obstruction. Tolerance of a calorie-rich, high-fat diet postresection may require tis7 and its target genes. The presence of luminal fat in the setting of tis7 deletion promotes an intestinal inflammatory response postresection.


Asunto(s)
Dieta Alta en Grasa/efectos adversos , Enteritis/etiología , Proteínas Inmediatas-Precoces/deficiencia , Obstrucción Intestinal/etiología , Intestino Delgado/metabolismo , Proteínas de la Membrana/deficiencia , Síndrome del Intestino Corto/complicaciones , Anastomosis Quirúrgica , Animales , Modelos Animales de Enfermedad , Enteritis/genética , Enteritis/metabolismo , Regulación de la Expresión Génica , Proteínas Inmediatas-Precoces/genética , Interleucina-6/metabolismo , Absorción Intestinal , Obstrucción Intestinal/genética , Obstrucción Intestinal/metabolismo , Intestino Delgado/cirugía , Metabolismo de los Lípidos , Proteínas de la Membrana/genética , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Síndrome del Intestino Corto/genética , Síndrome del Intestino Corto/metabolismo , Factores de Tiempo
16.
J Minim Invasive Gynecol ; 20(1): 107-11, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23312251

RESUMEN

Essure hysteroscopic sterilization is an effective permanent contraception option for women, with a 99.83% effectiveness rate. To date, more than 600,000 Essure procedures have been performed worldwide. This case report describes bilateral Essure insert placement, after which the left insert was subsequently expelled after hysterosalpingogram (HSG)-confirmed correct bilateral insert placement and bilateral tubal occlusion. Although insert expulsion has been reported before a 3-month post-procedure HSG, this is the first published report of expulsion after a confirmatory 3-month post-procedure HSG. Because there now exists documentation of Essure insert expulsion after a 3-month confirmatory HSG, physicians and patients should be informed of this rare occurrence. Further investigation into the causes of such an event is warranted.


Asunto(s)
Histerosalpingografía , Expulsión de Dispositivo Intrauterino , Dispositivos Intrauterinos , Esterilización Tubaria/métodos , Adulto , Femenino , Humanos , Histerosalpingografía/métodos , Salpingectomía , Esterilización Reproductiva/métodos , Esterilización Tubaria/instrumentación
17.
Work ; 39(2): 113-23, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21815312

RESUMEN

OBJECTIVE: This study is an interventional evaluation of a post-offer employment testing. The study is designed to determine if shoulder injury rates are lowered when employees are placed at jobs they demonstrate the physical ability to perform. METHODS: A physical capacity evaluation based testing protocol was utilized to determine if each new employee had the physical work capacity to perform the job for which they were hired. Injuries to the shoulder were specifically scrutinized. The interventional group was compared to a historical control. RESULTS: The incidence of shoulder injuries was 0% in the tested group and 3.8% in the untested historical control. Over a 6 year study timeframe the utilization of physical capacity testing for work placement appeared to be the major factor in decreasing work related shoulder injuries. The annual cost of administering the tests for three years was $9,543, while the net annual cost savings was $124,451. This represented a 37% decrease in medical costs for shoulder and other work-related injuries. For every dollar spent on testing there was a $14 savings in medical costs secondary to injury prevention. CONCLUSION: The use of post-offer physical capacity testing resulted in a substantial and noticeable decrease in shoulder related non-accidental injuries. Furthermore, it is evident that a properly conceived and implemented post-offer testing program may help in the reduction of work-related injuries.


Asunto(s)
Enfermedades Musculoesqueléticas/economía , Enfermedades Profesionales/economía , Lesiones del Hombro , Evaluación de Capacidad de Trabajo , Adulto , Análisis Costo-Beneficio , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Musculoesqueléticas/prevención & control , Enfermedades Profesionales/prevención & control , Gestión de Riesgos/economía , Gestión de Riesgos/métodos , Adulto Joven
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