Thesis (MHSc--Health Science) -- Auckland University of Technology, 2004. / Also held in print (114 leaves, 30 cm.) in North Shore Theses Collection (T 610.730690993 MCC).

Thesis (M.S. in Nur.)--University of Texas at Austin, 1960. / Vita. Degree awarded June 1960. eContent provider-neutral record in process. Description based on print version record. Bibliography: l. 25-26.

Thesis (M.D.S.)--University of Hong Kong, 2001. / Includes bibliographical references (leaves 86-107). Also available in print.

Thesis (M.A.Sc.) - Simon Fraser University, 2007. / Theses (School of Engineering Science) / Simon Fraser University. Also issued in digital format and available on the World Wide Web.

Thesis (doctoral)--Københavns universitet.

Thesis (Ph. D.)--University of Wisconsin--Madison, 1970. / Typescript. Vita. Description based on print version record. Includes bibliographical references.

The purpose of this study was to determine if obese patients have a different sensory regression time from subarachnoid block than non-obese patients using hyperbaric 0.75% bupivacaine. A quasi-experimental design was used. Twenty patients were separated into two groups; one group was classified as obese, and the other group was classified as non-obese. The data consisting of age, height, weight, sex, and surgical procedure were recorded preoperatively. All the patients received hyperbaric 0.75% bupivacaine via subarachnoid puncture. The levels of spinal anesthesia were recorded at the highest level achieved. The injection time was also recorded. When the surgery was completed, the patient was transferred to the recovery room and levels of sensory blockade were checked by pin-prick with an 18-gauge needle every 10 minutes until complete recovery from the spinal anesthesia had been achieved. The hypothesis, there will be no difference in sensory regression time from SAB with hyperbaric 0.75% bupivacaine between obese and non-obese patients, failed to be rejected. No statistically significant difference, using linear regression analysis, was found in mean regression time between groups (obese versus non-obese).

Seven orthopedic surgery patients requiring the use of a tourniquet were studied. The hypothesis stated that tourniquet application does not affect coagulation. A total of 5 blood samples were drawn perioperatively (preoperative, 5 minutes after induction of anesthesia, 30 minutes after tourniquet inflation, 2 - 5 minutes after tourniquet deflation, and 30 minutes after tourniquet deflation. For each sample, TEG parameters (R, R + k, MA and α) were measured. The value for each TEG parameter was compared by analysis of variance (ANOVA), then the samples were contrasted and examined by repeated measures ANOVA. None of the TEG parameters showed a statistically significant difference in the blood samples before, during or after tourniquet application. The hypothesis could not be rejected at the α = .05 level of significance. A t test was used to examine the effect of anesthesia on coagulation. The TEG parameters indicated a significant relationship between the TEG values R and R + k, and a near significant relationship between TEG values MA and a and the administration of anesthesia. It was concluded that tourniquet use does not effect coagulation when applied 2 hours or less. However, anesthesia had a significant effect on TEG parameters R and R + k. The clinical significance of this effect was questionable since the type of anesthesia varied in some patients, and none of the patients in the study demonstrated symptoms of coagulopathy.

No description available.

The United States is ranked first for health care expenditure and 11th for quality of care. Surgical care is complex, multifactorial, and medical expenses continue to increase. The necessity for surgery normally disconnects the patient from their primary care provider, frequently resulting in uncoordinated care between medical providers regarding surgical care. A fragmented healthcare system results in unnecessary diagnostic labs and tests, insufficient surgical care resources, and patients experiencing a lapse in their medical care. If adopted, the Perioperative Surgical Home (PSH) model has the opportunity to improve patient outcomes by increasing patient satisfaction rates while decreasing surgical complications and hospital stay duration. The PSH model is patient-centered, and directed by anesthesia providers coordinating surgical care by adequately optimizing patients for surgery. The five model components are: patient involvement, comprehensiveness, coordination of care, accessibility, and commitment to quality and safety. Purpose: The purpose of this project was to perform a needs assessment at a Central Phoenix Hospital to identify if there was a need to implement the PSH model to decrease surgical complications and 30-day surgical hospital readmission rates. Methods: This was a non-experimental needs assessment. Retrospective data collection was used to explore and identify if the PSH model was needed at this Phoenix hospital. A needs assessment tool was created guided by the Rothwell and Kazana's needs assessment model utilizing their five key phases. The General Systems Theory was used to assess the complexity of an open surgical system to identify gaps in performance and results. Results: Data collected from fiscal year 2015 demonstrated a total of 7,829 surgical cases were performed at this hospital. The number of patients with a surgical complication was 826 (10.6%). A reported 147 (1.9%) patients had a surgical hospital readmission at this facility. Data from fiscal year 2016 demonstrated 7,778 (10.3%) total surgical cases. The number of surgical complications reported was 800 (1.5%). A reported 116 patients had a hospital surgical readmission at this facility. Conclusion: The reported high health care expenditure and low quality of care received in the U.S. supports the need to improve our health care delivery system with models such as the PSH. There was not an obvious problem in performance of surgical complications and 30-day surgical hospital readmission rates. There were identified system gaps in data collection of surgical reporting that correlate with clinical practice. These findings were the starting point for a needs analysis to follow by focusing on development and implementation of the PSH model if adopted.