Explain how multidisciplinary collaboration can affect clinical decision making.
Discuss how collaboration can lead to improved patient outcomes.
Discuss how lack of collaboration can lead to poor patient outcomes.
Identify three barriers to professional collaboration among healthcare professionals and patients?
What are the five best ways to promote professional collaboration in pediatric primary care?
How can the nurse practitioner encourage and support collaboration among the patient, family, caregivers, and healthcare professionals?
Measurement of ICG requires the subjects to lay in a supine position without any movement to cancel out the artifacts that are caused due to other body signals which lead to unwanted changes of the signal recorded and make the patient uncomfortable. Presence of these artifacts makes it difficult for the people reading the signals and also affect the diagnosis leading to results that are inaccurate. These artifacts have to be removed before monitoring the signals to take correct decisions through filtering. Most of these artifacts are non-stationary in nature and cannot be predicted. Artifacts that are prominent in TEB include those varying with the changes that occur in surroundings like power line interference which makes base line of the original signal to change and with the movement of patient. Some artifacts occur from inside our body like Respiratory artifact that is prominent in ICG .Often patients are required to hold their breath to cancel out this artifact, but it is shown in [5Quesnay] that this may affect the stroke volume parameter. There are also others like Motion artifacts and Electrode artifacts which bring changes to the signals that are unwanted. Filtering methods for processing the artifacts are either adaptive or non-adaptive. Since the artifacts that are to be processed in the signals obtained are ever changing in nature, non-adaptive filters that have linear transfer functions doesn’t provide good results in the process. Whereas time varying potentials can be detected using adaptive filtering techniques whose filter specifications change at every step. In [14Huang] they used LMS algorithm based adaptive filter for cancellation fo motion artifacts and got satisfactory results. In [15Allan] Allan et.al used a scaled fourier linear combined (SFLC) technique is proposed for filtering noncorrelated noise in ICG. They have succeeded in proving that their proposed method could remove noises that are not in synchronization with heart rate. In [16Dormer] used SFLC-RLS filter which shows improvement in performance compared to SFLC-LMS filter used in [15Allan]. [17Pandey] used LMS based adaptive filtering to remove respiratory artifacts in Impedance cardiogram signal. In this paper we discussed application of Least Mean Square (LMS) algorithm and its variants Normalized LMS (NLMS), Time varying step size (TVSLMS) Adaptive step size (ASLMS) and Constrained stability LMS (CSLMS) in ICG signals for artifact removal. Along with these algorithms, signed regressor form of these variants which decreases the number of computations are also used. The artifacts that are considered in this paper are Power Line Interference (PLI), Respiratory artifacts, Motion artifacts (MA), Muscle artifacts. Section II describes the filtering techniques that are used on ICG signals in brief. Section III provides the information on data acquisition using VU-AMS device. The results and discussions of the techniques used are given in section IV followed by conclusions.>GET ANSWER