Audit report on Jasper County, Iowa for the year ended June 30, 2007

Audit report on Jasper County, Iowa for the year ended June 30, 2007

Audit report on the Heart of Iowa Regional Transit Agency, Des Moines, for the year ended June 30, 2006

Audit report on the Heart of Iowa Regional Transit Agency, Des Moines, for the year ended June 30, 2006.

Audit report on Adams County, Iowa for the year ended June 30, 2006

Audit report on Adams County, Iowa for the year ended June 30, 2006.

Audit report on the Pocahontas County Solid Waste Commission for the year ended June 30, 2006.

Audit report on the Pocahontas County Solid Waste Commission for the year ended June 30, 2006.

Audit report on the City of Durant, Iowa for the year ended June 30, 2006

Audit report on the City of Durant, Iowa for the year ended June 30, 2006.

Audit report on the City of Mount Ayr, Iowa for the year ended June 30, 2006.

Audit report on the City of Mount Ayr, Iowa for the year ended June 30, 2006.

Audit report on the City of Hazleton, Iowa for the year ended June 30, 2006.

Audit report on the City of Hazleton, Iowa for the year ended June 30, 2006.

Audit report on the Crawford County Area Solid Waste Agency Commission for the year ended June 30, 2006.

Audit report on the Crawford County Area Solid Waste Agency Commission for the year ended June 30, 2006.

Influence of the quality of nursing on the duration of weaning from mechanical ventilation in patients with chronic obstructive pulmonary disease.

OBJECTIVE: To evaluate the influence of nursing on the duration of weaning from mechanical ventilation in patients with chronic obstructive pulmonary disease. DESIGN: Data were collected prospectively over a 1-yr period (study year) and compared with previously collected prospective data recorded in our chronic obstructive pulmonary disease database during a 5-yr period. SETTING: The medical intensive care unit (ICU) of a university hospital. PATIENTS: Eighty-seven patients with chronic obstructive pulmonary disease. Fifteen patients had chronic obstructive pulmonary disease that required mechanical ventilation for acute exacerbation of their disease (study year), and 72 were patients with chronic obstructive pulmonary disease from the previously collected data. INTERVENTIONS: The ICU course (duration of mechanical ventilation, mortality) was recorded, as well as several respiratory parameters (pulmonary function tests and arterial blood gases in stable conditions, and nutritional status), and they were compared with an "index of nursing." MEASUREMENTS AND MAIN RESULTS: We developed an "index of nursing", comparing the effective workforce of the nurses (number and qualifications) with the ideal workforce required by the number of patients and the severity of their diseases. A value of 1.0 represented a perfect match between the needed and the effectively present nurses, whereas a lesser value signified a diminished available workforce. This index was compared with the complications and duration of weaning from mechanical ventilation. During the first 5 yrs, the duration of mechanical ventilation increased progressively from 7.3 +/- 8.0 to 38.2 +/- 25.8 days (p = .006). A significant inverse correlation between the duration of mechanical ventilation and the nursing index (p = .025) was found. In the sixth comparative year, the number of nurses increased (nursing index = 1.05) and the duration of mechanical ventilation decreased to 9.9 +/- 13 days (p < .001, yr 5 vs. yr 6). CONCLUSIONS: The quality of nursing appears to be a measurable and critical factor in the weaning from mechanical ventilation of patients with chronic obstructive pulmonary disease. Below a threshold in the available workforce of ICU nurses, the weaning duration of patients with chronic obstructive pulmonary disease increases dramatically. Therefore, very close attention should be given to the education and number of ICU nurses.

Audit report on O’Brien County, Iowa for the year ended June 30, 2006.

Audit report on O’Brien County, Iowa for the year ended June 30, 2006.

Audit report on Audubon County, Iowa for the year ended June 30, 2006.

Audit report on Audubon County, Iowa for the year ended June 30, 2006.

Audit report on the City of Wall Lake, Iowa for the year ended June 30, 2006.

Audit report on the City of Wall Lake, Iowa for the year ended June 30, 2006.

Audit report on Lee County, Iowa for the year ended June 30, 2006.

Audit report on Lee County, Iowa for the year ended June 30, 2006.

Audit report on Taylor County, Iowa for the year ended June 30, 2006.

Audit report on Taylor County, Iowa for the year ended June 30, 2006.

Audit report on the City of Grimes, Iowa for the year ended June 30, 2006.

Audit report on the City of Grimes, Iowa for the year ended June 30, 2006.