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https://www.readbyqxmd.com/read/28339769/incidence-and-potential-risk-factors-for-hospital-acquired-pneumonia-in-an-emergency-department-of-surgery
#1
Marie Stenlund, Rune Sjödahl, R N Pia Yngman-Uhlin
Objective: Hospital-acquired pneumonia (HAP) is associated with high mortality and is the second most common nosocomial infection. The aim of this study was to calculate the incidence and to identify potential risk factors for HAP in an emergency ward for surgical patients admitted because of acute abdomen or trauma. Design: A structured review of medical records was conducted. Patients diagnosed with pneumonia >48 h after admittance, were compared with a randomly chosen age-matched reference group...
February 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28333819/practice-bulletin-no-177-obstetric-analgesia-and-anesthesia
#2
(no author information available yet)
Labor causes severe pain for many women. There is no other circumstance in which it is considered acceptable for an individual to experience untreated severe pain that is amenable to safe intervention while the individual is under a physician's care. Many women desire pain management during labor and delivery, and there are many medical indications for analgesia and anesthesia during labor and delivery. In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333811/practice-bulletin-no-177-summary-obstetric-analgesia-and-anesthesia
#3
(no author information available yet)
Labor causes severe pain for many women. There is no other circumstance in which it is considered acceptable for an individual to experience untreated severe pain that is amenable to safe intervention while the individual is under a physician's care. Many women desire pain management during labor and delivery, and there are many medical indications for analgesia and anesthesia during labor and delivery. In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28331772/an-automated-gravity-driven-csf-drainage-system-decreases-complications-and-lowers-costs
#4
Robert E Lieberson, Jan Eckermann, William Meyer, Tung Trang
BACKGROUND: FlowSafe(TM) (BeckerSmith Medical, Irvine, CA, USA) is a novel, robotic, external lumbar drainage (ELD) system, which was designed to control cerebrospinal fluid (CSF) drainage, reduce complications, and decrease treatment costs. METHODS:  Forty-seven consecutive neurosurgical patients requiring ELD were treated using the FlowSafe system. RESULTS: In 39 of 40 patients with traumatic and surgical dural openings, potential CSF leaks were avoided...
February 3, 2017: Curēus
https://www.readbyqxmd.com/read/28325381/-early-treatment-and-nursing-role-in-the-case-of-a-haemorrhagic-stroke
#5
Séverine Héraud-Carré, Bruno Le Roy, Gladys Prével
Paediatric stroke constitute a medical and/or surgical emergency. The speed and timeliness of the treatment have a significant impact on the prognosis. The nursing role, from carrying out continuous observation to specific procedures, is essential in the assessment, the care pathway and the short-, medium- and long-term outcome for the child.
March 2017: Soins. Pédiatrie, Puériculture
https://www.readbyqxmd.com/read/28323687/multilevel-factors-associated-with-injurious-falls-in-acute-care-hospitals
#6
Yunchuan Lucy Zhao, Marjorie Bott, Jianghua He, Heejung Kim, Nancy Dunton
Using National Database of Nursing Quality Indicators data from July 2013 to June 2014, this correlational study examined the associations of injurious falls among all patient falls with multilevel factors in hospitals. The sample included all falls recorded in adult medical, surgical, combined medical-surgical, and step-down units (N = 2299) in participating hospitals (N = 488). Hierarchical negative binominal regression analyses were performed. Results revealed hospital and unit organizational factors associated with inpatient injurious falls...
March 20, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28322664/trust-development-with-the-spanish-speaking-mexican-american-patient
#7
Sharon M Jones
Interpersonal trust between patient and nurse is important in patient-centered care. Trust development may be more difficult if the patient and nurse do not speak the same language. In this grounded theory study, Spanish-speaking Mexican American adults ( n = 20) hospitalized on a medical-surgical or obstetric unit in the Midwestern United States were interviewed. Through data analysis, a model of how trust develops between nurse and patient revealed eight categories and the core category Caring for Me Well Even When Not Understanding Me...
January 1, 2017: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/28321988/a-quality-improvement-initiative-to-optimize-dosing-of-surgical-antimicrobial-prophylaxis
#8
Thomas J Caruso, Ellen Wang, Hayden T Schwenk, David Scheinker, Calida Yeverino, Mary Tweedy, Manjit Maheru, Paul J Sharek
BACKGROUND: The risk of surgical site infections is reduced with appropriate timing and dosing of preoperative antimicrobials. Based on evolving national guidelines, we increased the preoperative dose of cefazolin from 25 to 30 mg·kg(-1) . This quality improvement project describes an improvement initiative to develop standard work processes to ensure appropriate dosing. AIMS: The primary aim was to deliver cefazolin 30 mg·kg(-1) to at least 90% of indicated patients...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28297072/operational-failures-detected-by-frontline-acute-care-nurses
#9
Kathleen R Stevens, Eileen P Engh, Heather Tubbs-Cooley, Deborah Marks Conley, Tammy Cupit, Ellen D'Errico, Pam DiNapoli, Joleen Lynn Fischer, Ruth Freed, Anne Marie Kotzer, Carolyn L Lindgren, Marie Ann Marino, Lisa Mestas, Jessica Perdue, Rebekah Powers, Patricia Radovich, Karen Rice, Linda P Riley, Peri Rosenfeld, Linda Roussel, Nancy A Ryan-Wenger, Linda Searle-Leach, Nicole M Shonka, Vicki L Smith, Laura Sweatt, Mary Townsend-Gervis, Ellen Wathen, Janice S Withycombe
Frontline nurses encounter operational failures (OFs), or breakdowns in system processes, that hinder care, erode quality, and threaten patient safety. Previous research has relied on external observers to identify OFs; nurses have been passive participants in the identification of system failures that impede their ability to deliver safe and effective care. To better understand frontline nurses' direct experiences with OFs in hospitals, we conducted a multi-site study within a national research network to describe the rate and categories of OFs detected by nurses as they provided direct patient care...
March 15, 2017: Research in Nursing & Health
https://www.readbyqxmd.com/read/28293996/effective-pain-management-in-patients-in-hospital
#10
Candy McCabe
Chronic pain is experienced by between one third and one half of the UK population. Nurses should ensure that patients' pain is assessed and managed when they present to hospital, including pre-existing chronic pain and acute pain as a result of trauma or surgical interventions. Acute pain that is inadequately managed may result in chronic pain, impeding the patient's return to normal function and daily activities. Depression and increasing age affect the likelihood of patients experiencing chronic pain. Nurses should be familiar with the pain assessment tools available for use with older people and be aware of the potential issues of polypharmacy and altered sensitivity to medication in older people...
March 15, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28293731/physical-function-and-health-related-quality-of-life-in-patients-undergoing-surgical-treatment-for-malignant-pleural-mesothelioma
#11
Takashi Tanaka, Shinichiro Morishita, Masaki Hashimoto, Yusuke Itani, Satoshi Mabuchi, Norihiko Kodama, Seiki Hasegawa, Kazuhisa Domen
INTRODUCTION: Malignant pleural mesothelioma (MPM) is a rare cancer that affects the thin cell wall lining of internal organs and structures. Studies have shown that patients with lung cancer have decreased pulmonary function and exercise capacity after pneumonectomy. However, to date, physical function and health-related quality of life (HRQOL) in surgically treated MPM patients have not been evaluated in detail. The aim of this study was to assess physical function and HRQOL of MPM patients following pleurectomy/decortication (P/D)...
March 14, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28293685/healthcare-team-perceptions-of-a-portal-for-parents-of-hospitalized-children-before-and-after-implementation
#12
Michelle M Kelly, Shannon M Dean, Pascale Carayon, Tosha B Wetterneck, Peter L T Hoonakker
BACKGROUND: Patient electronic health record (EHR) portals can enhance patient and family engagement by providing information and a way to communicate with their healthcare team (HCT). However, portal implementation has been limited to ambulatory settings and met with resistance from HCTs. OBJECTIVE: We evaluated HCT perceptions before and 6-months after implementation of an inpatient EHR portal application on a tablet computer given to parents of hospitalized children...
March 15, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28285427/association-between-intraabdominal-pressure-during-gynaecologic-laparoscopy-and-postoperative-pain
#13
Sudip Kundu, Clara Weiss, Hermann Hertel, Peter Hillemanns, Rüdiger Klapdor, Philipp Soergel
PURPOSE: Laparoscopy is nowadays a well-established surgical method and plays a main role in an ever-increasing range of indications in gynaecology. High-quality studies of surgical techniques are necessary to improve the quality of patient care. The present study aims at evaluating postoperative pain after gynaecological laparoscopy depending on the intraoperative CO2 pressure. METHODS: In a prospective, monocentric, randomized single-blind study at the Department of Gynaecology and Obstetrics at the Hannover Medical School, we include patients scheduled for different laparoscopic procedures...
March 11, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28282305/ce-original-research-identifying-hospitalized-patients-at-risk-for-harm-a-comparison-of-nurse-perceptions-vs-electronic-risk-assessment-tool-scores
#14
Andrea Stafos, Susan Stark, Kathryn Barbay, Kristen Frost, David Jackel, Lindsey Peters, Elizabeth Riggs, Susan Schedler, Shalan Stroud
: Objective: In many hospitals, nurse-led "safety huddles" are used to relay patient safety information, although whether this effectively identifies patients at risk for harm has not been determined. New electronic risk assessment tools are designed to identify patients at risk for harm during hospitalization, based on specific markers in the electronic health record. This study sought to compare the results of both methods. The findings may help to enhance decision making at the level of care delivery. METHODS: A nonexperimental correlational study was conducted over a three-week period in 2015 in a large metropolitan acute care community hospital...
April 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28274986/use-of-simulation-training-to-prepare-pharmacy-residents-for-medical-emergencies
#15
Melissa L Thompson Bastin, Aaron M Cook, Alexander H Flannery
PURPOSE: The use of high-fidelity simulation training for preparing pharmacy residents for various high-stress and high-impact medical emergencies and the impact of this training on pharmacy residents' perception of preparedness are described. SUMMARY: During the 2015-16 residency year at the University of Kentucky Medical Center, simulation training, in addition to lecture-based orientation training, was chosen as a method to reinforce skills and knowledge learned throughout the orientation, before residents began working on-call shifts...
March 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28267682/a-retrospective-descriptive-comparative-study-to-identify-patient-variables-that-contribute-to-the-development-of-deep-tissue-injury-among-patients-in-intensive-care-units
#16
Holly Kirkland-Kyhn, Oleg Teleten, Machelle Wilson
Deep tissue injury (DTI) may develop in critically ill patients despite implementation of preventive interventions. A retrospective, descriptive study was conducted in a 620-bed, level 1 trauma, academic medical center with 7 adult intensive care units ([ICUs] cardiac surgery, trauma surgery, burn surgery, med-surgery, neurosurgery, medical, and transfer) among patients treated from January 1, 2010 to January 1, 2015. All patients 18 years of age or older that developed a sacral DTI that evolved into a Stage 3, Stage 4, or unstageable hospital-acquired pressure ulcers (HAPU) in the ICU were included...
February 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28267680/pressure-ulcer-prevalence-and-care-in-indonesian-hospitals-a-multicenter-cross-sectional-evaluation-using-an-extended-donabedian-model
#17
Yufitriana Amir, Frans E S Tan, Ruud Halfens, Christa Lohrmann, Jos Schols
Although the number of studies on pressure ulcer (PU) occurrence continues to grow, research regarding the quality of PU care and its effect on outcomes is limited. Using an extended Donabedian model, a 1-day, multicenter, cross-sectional evaluation of the quality of PU care was conducted in a convenience sample of Indonesian hospitals among patients ≥18 years of age in the medical, surgical, and intensive care units. Structure (ie, hospital attributes), process (recommended PU preventive measures), and outcome indicators (nosocomial PU prevalence excluding nonblanchable erythema), along with patient characteristics (age, gender, ethnicity, admission days, diseases [per ICD-10], recent surgery, PU categorization [4 categories according to National Pressure Ulcer Advisory Panel-European Pressure Ulcer Advisory Panel guidelines], PU history, care dependency, and Braden score) were examined...
February 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28267128/medical-adhesive-related-skin-injury-following-emergent-appendectomy-a-case-study-of-marsi-and-missed-opportunities-in-nursing-care
#18
Sylvia E Britt, Karen M Coles, Shannon S Polson
BACKGROUND: The potential for skin damage from adhesive products is documented in the literature. Nevertheless, health care providers continue to lack understanding of the impact and seriousness of skin injury associated with use of tapes or other adhesive devices when applied to a patient with a history or hypersensitivity or allergy to adhesives. CASE: A 67-year-old woman with a history of tape allergy underwent emergency appendectomy. Initial removal of an adhesive bandage placed over the surgical incision revealed medical adhesive-related skin injury (MARSI)...
March 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28263192/the-confusion-assessment-method-for-the-icu-7-delirium-severity-scale-a-novel-delirium-severity-instrument-for-use-in-the-icu
#19
Babar A Khan, Anthony J Perkins, Sujuan Gao, Siu L Hui, Noll L Campbell, Mark O Farber, Linda L Chlan, Malaz A Boustani
OBJECTIVES: Delirium severity is independently associated with longer hospital stays, nursing home placement, and death in patients outside the ICU. Delirium severity in the ICU is not routinely measured because the available instruments are difficult to complete in critically ill patients. We designed our study to assess the reliability and validity of a new ICU delirium severity tool, the Confusion Assessment Method for the ICU-7 delirium severity scale. DESIGN: Observational cohort study...
March 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28262654/-difficulties-in-caring-for-psychiatric-patient-as-experienced-by-non-psychiatric-nurses
#20
Jaewon Joung, Mi Young Jang, Jihyun Shim, Yoonhi Ko, Sung Hee Shin
PURPOSE: The purpose of this study was to identify non-psychiatric nurses' difficulties in caring for patients with mental illness. METHODS: Data were collected from eighteen general medical-surgical nurses working at a university hospital in Seoul, Korea. This study involved two focus group discussions and three in-depth individual interviews. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis...
February 2017: Journal of Korean Academy of Nursing
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