Try a new search

Format these results:

Searched for:

person:linkr01

in-biosketch:yes

Total Results:

9


Acute Care Surgeons' Response to the COVID-19 Pandemic: Observations and Strategies From the Epicenter of the American Crisis

Klein, Michael J; Frangos, Spiros G; Krowsoski, Leandra; Tandon, Manish; Bukur, Marko; Parikh, Manish; Cohen, Steven M; Carter, Joseph; Link, Robert Nathan; Uppal, Amit; Pachter, Hersch Leon; Berry, Cherisse
PMID: 32675500
ISSN: 1528-1140
CID: 4574222

Brief report: Failure of an electronic medical record tool to improve pain assessment documentation

Saigh, Orit; Triola, Marc M; Link, R Nathan
OBJECTIVE: To comply with pain management standards, Bellevue Hospital in New York City implemented a mandatory computerized pain assessment screen (PAS) in its electronic medical record (EMR) system for every outpatient encounter. We assessed provider acceptance of the instrument and examined whether the intervention led to increased documentation of pain-related diagnoses or inquiries. DESIGN: Cross-sectional survey; a pre- and posthistorically controlled observational study. SUBJECTS AND MEASUREMENTS: The utility of the computerized tool to medicine housestaff and attendings was assessed by an anonymous survey. We conducted an electronic chart review comparing all adult primary care patient encounters over a 2-day period 6 months prior to implementation of the PAS and on 2 days 6 months after its implementation. RESULTS: Forty-seven percent of survey respondents felt that the computerized assessment tool was 'somewhat difficult' or 'very difficult' to use. The majority of respondents (79%) felt the tool did not change their pain assessment practice. Of 265 preintervention patients and 364 postintervention patients seen in the clinic, 42% and 37% had pain-related diagnoses, respectively (P=.29). Pain inquiry by the physician was noted for 49% of preintervention patients and 44% of the postintervention patients (P=.26). In 55% of postintervention encounters, there was discordance between the pain documentation using the PAS tool and the free text section of the medical note. CONCLUSION: A mandatory computerized pain assessment tool did not lead to an increase in pain-related diagnoses and may have hindered the documentation of pain assessment because of the perceived burden of using the application
PMCID:1484649
PMID: 16606379
ISSN: 1525-1497
CID: 67351

General internal medicine

Lipkin M Jr; Link RN; Schwartz MD
Internists advanced toward a patient care model based on critical, qualitative, and quantitative assessment of clinical care processes and outcomes. The complete internist must consider social context as well as traditional risk factors in promoting the health of patients
PMID: 8182844
ISSN: 0098-7484
CID: 12963

PRISONERS ACCESS TO MEDICATIONS - REPLY [Letter]

KELLER, AS; LINK, RN; BICKELL, NA; CHARAP, MH; KALET, AL; SCHWARTZ, MD
ISI:A1993LB45000026
ISSN: 0098-7484
CID: 54182

Diabetic ketoacidosis in prisoners without access to insulin [see comments] [Comment]

Keller AS; Link RN; Bickell NA; Charap MH; Kalet AL; Schwartz MD
OBJECTIVE--To assess the cause and clinical severity of diabetic ketoacidosis in male prisoners hospitalized in New York City. DESIGN--Retrospective chart review. SETTING--A municipal hospital in New York City. PATIENTS--Forty-nine adult male prisoners with a total of 54 hospital admissions for diabetic ketoacidosis between January 1, 1989, and June 30, 1991. MAIN OUTCOME MEASURES--Charts were reviewed for diabetic and medical history, time from arrest until hospitalization, cause of diabetic ketoacidosis, admission laboratory data, and hospital course. RESULTS--Thirty-eight (70%) of the 54 admissions for diabetic ketoacidosis among prisoners occurred because prisoners had not received insulin during the period immediately following arrest (mean number of days from arrest until hospitalization was 2.5). All of these individuals had a history of insulin-dependent diabetes and were reportedly compliant with their insulin regimen at the time of arrest. Admission laboratory data for this group of prisoners included a mean serum glucose level of 27.4 mmol/L (495 mg/dL) and a mean serum bicarbonate level of 14.4 mmol/L. Mean number of days in the hospital was 3.4 including a mean of 1 day in an intensive care unit. CONCLUSIONS--Inadequate access to medication results in serious sequelae for recently arrested prisoners in New York City with insulin-dependent diabetes. Access to health care for recently arrested prisoners needs to be improved
PMID: 8421367
ISSN: 0098-7484
CID: 13252

Physician-patient gender congruence and the physical examination

Link RN; Zabar SR
To assess the hypothesis that breast, genitourinary (GU), and rectal examinations are performed more frequently when the physician and patient are of the same gender, the authors reviewed the records of 529 patients in a housestaff medical clinic. They found no significant difference between gender-congruent and gender-incongruent patient encounters in the rates of these examinations. However, higher rates of performance by primary care housestaff compared with those of internal medicine housestaff were noted in all categories. The authors conclude that performances of breast, GU, and rectal examinations were not related to gender congruence but may have been associated with the houseofficers' training program
PMID: 1744765
ISSN: 0884-8734
CID: 13926

Attitudes of house officers toward the autopsy

Wilkes MS; Link RN; Jacobs TA; Fortin AH; Felix JC
STUDY OBJECTIVE: To assess the attitudes of house officers in internal medicine and pathology about the value and use of the autopsy. DESIGN: Self-administered multiple-choice questionnaire. SETTING: Two New York City urban teaching hospitals. SUBJECTS: 112 internal medicine and 37 pathology house officers who were on site during the survey period. MAIN RESULTS: Most internal medicine house officers (86%) felt that the autopsy rate was too low and needed to be increased. The most common reason the residents cited for the low rate was the reluctance of families to grant permission. A majority of medicine housestaff (78%) felt they needed more instruction on how to ask for an autopsy, and 34% had never received feedback from the pathology department on autopsy results. Most pathology residents (94%) felt the autopsy rate was too low; the most common reasons they cited for the low rate were reluctance of clinicians to request permission and clinicians' fears of being sued for malpractice. CONCLUSIONS: House officers in internal medicine and pathology agreed that autopsies should be performed more frequently, and identified problems in obtaining autopsies that should be addressed by educational, organizational, and regulatory strategies
PMID: 2313404
ISSN: 0884-8734
CID: 18936

RESIDENTS ATTITUDES TOWARD THE AUTOPSY [Meeting Abstract]

Wilkes, MS; Fortin, AH; Link, RN
ISI:A1989U004403448
ISSN: 0009-9279
CID: 31728

Concerns of medical and pediatric house officers about acquiring AIDS from their patients

Link RN; Feingold AR; Charap MH; Freeman K; Shelov SP
To assess the degree of house officers' concerns about acquiring AIDS (acquired immunodeficiency syndrome) from their patients, we surveyed 263 medical and pediatric interns and residents in four housestaff training programs affiliated with seven New York City hospitals with large AIDS patient populations; 258 questionnaires (98 per cent) were returned. Thirty-six per cent of medical and 17 per cent of pediatric house officers reported percutaneous exposures to needles contaminated with blood of AIDS patients. Forty-eight per cent of medical and 30 per cent of pediatric house officers reported a moderate to major concern about acquiring AIDS from their patients. Greater concern about personal risk was noted in those house officers who were earlier in their residency training, who reported having treated a greater number of AIDS patients, and who were in medicine rather than pediatrics programs. Twenty-five per cent of all respondents reported that they would not continue to care for AIDS patients if given a choice. The results demonstrate a substantial degree of concern about acquiring AIDS among house officers caring for AIDS patients and suggest the need for housestaff program administrators for formally address these concerns
PMCID:1349375
PMID: 3348474
ISSN: 0090-0036
CID: 11133