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Medical Surgical Nursing

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https://www.readbyqxmd.com/read/28926873/-to-enhance-clinical-application-of-comprehensive-geriatric-assessment-in-elderly-inpatients-with-non-cardiac-surgical-operation
#1
X M Wang, Y Liu
In this commentary article, we introduce the definition, evaluative contents and methods of comprehensive geriatric assessment (CGA), as well as its successful application in Western countries. CGA is a multidisciplinary diagnosis and treatment process that identifies medical, psychosocial, and functional capabilities of elderly adults to develop plans including overall treatment, nursing, and follow-up to maximize overall health with aging. How to change this situation has become an important challenge due to the significant increase in postoperative complications, mortality, and treatment costs for elderly patients with surgical diseases...
September 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28926087/self-reported-function-more-informative-than-frailty-phenotype-in-predicting-adverse-postoperative-course-in-older-adults
#2
Alok Kapoor, Theofilos Matheos, Matthias Walz, Christine McDonough, Abiramy Maheswaran, Evan Ruppell, Deeqo Mohamud, Nicholas Shaffer, Yanhua Zhou, Shubjeet Kaur, Stephen Heard, Sybil Crawford, Howard Cabral, Daniel K White, Heena Santry, Alan Jette, Roger Fielding, Rebecca A Silliman, Jerry Gurwitz
BACKGROUND/OBJECTIVE: Current preoperative assessment tools such as the American College of Surgeons Surgical Risk Calculator (ACS Calculator) are suboptimal for evaluating older adults. The objective was to evaluate and compare the performance of the ACS Calculator for predicting risk of serious postoperative complications with the addition of self-reported physical function versus a frailty score. DESIGN: Prospective cohort. SETTING: Two tertiary care academic medical centers in Massachusetts...
September 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28923988/contemporary-management-of-cardiogenic-shock-a-scientific-statement-from-the-american-heart-association
#3
REVIEW
Sean van Diepen, Jason N Katz, Nancy M Albert, Timothy D Henry, Alice K Jacobs, Navin K Kapur, Ahmet Kilic, Venu Menon, E Magnus Ohman, Nancy K Sweitzer, Holger Thiele, Jeffrey B Washam, Mauricio G Cohen
Cardiogenic shock is a high-acuity, potentially complex, and hemodynamically diverse state of end-organ hypoperfusion that is frequently associated with multisystem organ failure. Despite improving survival in recent years, patient morbidity and mortality remain high, and there are few evidence-based therapeutic interventions known to clearly improve patient outcomes. This scientific statement on cardiogenic shock summarizes the epidemiology, pathophysiology, causes, and outcomes of cardiogenic shock; reviews contemporary best medical, surgical, mechanical circulatory support, and palliative care practices; advocates for the development of regionalized systems of care; and outlines future research priorities...
September 18, 2017: Circulation
https://www.readbyqxmd.com/read/28919771/the-challenge-of-perioperative-pain-management-in-opioid-tolerant-patients
#4
REVIEW
Flaminia Coluzzi, Francesca Bifulco, Arturo Cuomo, Mario Dauri, Claudio Leonardi, Rita Maria Melotti, Silvia Natoli, Patrizia Romualdi, Gennaro Savoia, Antonio Corcione
The increasing number of opioid users among chronic pain patients, and opioid abusers among the general population, makes perioperative pain management challenging for health care professionals. Anesthesiologists, surgeons, and nurses should be familiar with some pharmacological phenomena which are typical of opioid users and abusers, such as tolerance, physical dependence, hyperalgesia, and addiction. Inadequate pain management is very common in these patients, due to common prejudices and fears. The target of preoperative evaluation is to identify comorbidities and risk factors and recognize signs and symptoms of opioid abuse and opioid withdrawal...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28914986/linkages-of-nursing-diagnoses-outcomes-and-interventions-performed-by-nurses-caring-for-medical-and-surgical-patients-using-a-decision-support-system
#5
Rita de Cassia Gengo E Silva, Regina Célia Dos Santos Diogo, Diná de Almeida Lopes Monteiro da Cruz, Doris Ortiz, Diley Ortiz, Heloísa Helena Ciqueto Peres, Sue Moorhead
No abstract text is available yet for this article.
September 15, 2017: International Journal of Nursing Knowledge
https://www.readbyqxmd.com/read/28905042/social-demographic-and-clinical-characteristics-of-patients-suffering-from-peripheral-vascular-disease-treated-surgically-compared-to-patients-treated-with-endovascular-angioplasty
#6
Renata Piotrkowska, Marek Dobosz, Janina Książek, Grzegorz Halena
INTRODUCTION: Atherosclerosis is the most common cause of chronic lower limb ischaemia. Many factors that have a crucial influence on the development of the disease, its course and prognosis have been identified. The risk factors seem to be subject to interventions due to their susceptibility to changes. It is important to increase the engagement of doctors and nurses performing the screening oriented on risk factors, medical consultation regarding giving up smoking, changing the diet and undertaking physical activity...
2017: Arch Med Sci Atheroscler Dis
https://www.readbyqxmd.com/read/28890209/nursing-workload-and-adherence-to-non-pharmacological-measures-in-the-prevention-of-ventilator-associated-pneumonia-a-pilot-study
#7
R Jam, O Hernández, J Mesquida, C Turégano, E Carrillo, R Pedragosa, V Gómez, L Martí, J Vallés, P Delgado-Hito
OBJECTIVE: To analyse whether adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia (VAP) is associated with nursing workload. METHODS: A prospective observational study performed in a single medical-surgical ICU. Nurses in charge of patients under ventilator support were assessed. VARIABLES: knowledge questionnaire, application of non-pharmacological VAP prevention measures, and workload (Nine Equivalents of Nursing Manpower Use Score)...
September 7, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28888685/predictive-factors-of-hospital-stay-mortality-and-functional-recovery-after-surgery-for-hip-fracture-in-elderly-patients
#8
T Pareja Sierra, I Bartolomé Martín, J Rodríguez Solís, L Bárcena Goitiandia, M Torralba González de Suso, M D Morales Sanz, M Hornillos Calvo
OBJECTIVES: Due to its high prevalence and serious consequences it is very important to be well aware of factors that might be related to medical complications, mortality, hospital stay and functional recovery in elderly patients with hip fracture. MATERIAL AND METHODS: A prospective study of a group of 130 patients aged over 75 years admitted for osteoporotic hip fracture. Their medical records, physical and cognitive status prior to the fall, fracture type and surgical treatment, medical complications and functional and social evolution after hospitalization were evaluated...
September 6, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28882927/sharp-instrument-injuries-among-hospital-healthcare-workers-in-mainland-china-a-cross-sectional-study
#9
Sheng-Li Huang, Qun Lu, Shan-Hong Fan, Zhi-Yong Zong, Tie-Ying Hou, Bai-Yi Chen, Jin-Ai Qin, Yao Suo, Xiao-Dong Gao, Ning-Ning Wang
OBJECTIVES: To determine the prevalence of sharp instrument injuries in hospital-based healthcare workers (HCWs) in mainland China and the contributing factors. DESIGN: Cross-sectional study. SETTING: The data were derived from public hospitals. PARTICIPANTS: A total of 360 hospitals were recruited in the study, including 289 general hospitals and 71 specialised hospitals. Among them, 194 are tertiary-level hospitals and 166 are secondary level...
September 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28881453/the-content-of-nurse-unit-managers-work-a-descriptive-study-using-daily-activity-diaries
#10
Herdís Sveinsdóttir, Katrín Blöndal, Heiður Hrund Jónsdóttir, Helga Bragadóttir
BACKGROUND: NUMs' job description in Icelandic hospitals has been revised and now also includes managerial and financial responsibilities. AIM: To describe the actual work activities of nurse unit managers (NUMs) in surgical and internal medicine services as self-documented and reflected in their job description. DESIGN: Prospective exploratory study. METHOD: The study's setting was the largest hospital in Iceland. Data were collected over 7 days from NUMs working on surgical and medical units with an activity diary listing five domains and 41 activities: 'management and planning' (seven activities), 'staff responsibility (seven activities), 'direct clinical work' (five activities), 'service' (12 activities) and 'other' (nine activities)...
September 7, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28870303/patient-satisfaction-after-total-knee-arthroplasty-a-realistic-or-imaginary-goal
#11
REVIEW
Emmanuel Gibon, Marla J Goodman, Stuart B Goodman
This article summarizes the current literature regarding patient satisfaction after total knee arthroplasty. In 10% to 15% of cases, the operation has not met the patients' expectations. The causes of this dissatisfaction are multifactorial, and include patient-related factors, details related to the surgical procedure and prosthesis chosen, perioperative factors, and factors associated with nursing and general medical care. However, surgeons must bear the brunt of patients' dissatisfaction. This dissatisfaction erodes the doctor-patient relationship, and may have implications in an emerging health care economy in which doctors and hospitals are reimbursed based on both clinical outcome and patient satisfaction...
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28867778/nurse-perceptions-of-artists-as-collaborators-in-interprofessional-care-teams
#12
Jill Sonke, Virginia Pesata, Jenny Baxley Lee, John Graham-Pole
Increased attention is being given to interprofessional collaboration in healthcare, which has been shown to improve patient satisfaction, patient safety, healthcare processes, and health outcomes. As the arts and artists are being more widely incorporated into healthcare settings throughout the world, professional artists are contributing to interprofessional care teams. A secondary directed content analysis of interviews with 31 nurses on a medical-surgical care unit investigated the roles and impacts of professional artists on the interprofessional care team...
August 30, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28865984/impact-of-surgical-intensive-care-unit-interdisciplinary-rounds-on-interprofessional-collaboration-and-quality-of-care-mixed-qualitative-quantitative-study
#13
Tatiana Urisman, Alberto Garcia, Hobart W Harris
BACKGROUND: Interprofessional collaboration is a key requirement for safe and effective care delivery in the critical care setting. To promote collaboration between care providers, intensive care unit interdisciplinary rounds have been introduced by multiple institutions and subsequent subjective improvements in interprofessional collaboration have been reported. However, only limited data are currently available regarding the impact of these rounds on objective patient care outcomes...
August 30, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28864690/interprofessional-team-assessments-of-the-patient-safety-climate-in-swedish-operating-rooms-a-cross-sectional-survey
#14
Camilla Göras, Maria Unbeck, Ulrica Nilsson, Anna Ehrenberg
BACKGROUND: A positive patient safety climate within teams has been associated with higher safety performance. The aim of this study was to describe and compare attitudes to patient safety among the various professionals in surgical teams in Swedish operating room (OR) departments. A further aim was to study nurse managers in the OR and medical directors' estimations of their staffs' attitudes to patient safety. METHODS: A cross-sectional survey with the Safety Attitudes Questionnaire (SAQ) was used to elicit estimations from surgical teams...
September 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28860402/sliding-hip-screw-versus-the-targon-pft-nail-for-trochanteric-hip-fractures-a-randomised-trial-of-400-patients
#15
RANDOMIZED CONTROLLED TRIAL
M J Parker, S Cawley
AIMS: To compare the outcomes for trochanteric fractures treated with a sliding hip screw (SHS) or a cephalomedullary nail. PATIENTS AND METHODS: A total of 400 patients with a trochanteric hip fracture were randomised to receive a SHS or a cephalomedullary nail (Targon PFT). All surviving patients were followed up to one year from injury. Functional outcome was assessed by a research nurse blinded to the implant used. RESULTS: Recovery of mobility, as assessed by a mobility scale, was superior for those treated with the intramedullary nail compared with the SHS at eight weeks, three and nine months (p-values between 0...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28858997/virtually-integrated-care-a-new-paradigm-in-patient-care-delivery
#16
Shannon Denney, Elizabeth Miller Evans
Current trends, including an aging population; the impact of the Affordable Care Act; increased complexity and acuity of patient needs; shorter hospital stays; and higher patient expectations have resulted in a significant demand for reconfiguration of the bedside nursing model. The health care system is further complicated by a shortage of highly trained nurses, challenging financial incentive models, and inefficient traditional staffing models. These challenges have increased the urgency for designing a more efficient, cost-effective care delivery model...
October 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/28858955/variability-in-acuity-in-acute-care
#17
Amy L Garcia
OBJECTIVE: This study was designed to describe variable acuity among 1 population of acute care patients. BACKGROUND: Acuity, defined as the individual patient need for nursing care, can inform level of care, nurse staffing, and the nurse-to-patient assignment. Nurse-generated data in the electronic health record can be mined and analyzed for decision support. METHODS: This study used a descriptive, retrospective analysis of repeated measures of acuity generated from 28 739 nursing assessments of 405 consecutive subjects treated for heart failure (HF) in a 455-bed southern hospital...
August 31, 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28853187/time-motion-analysis-of-nursing-work-in-icu-telemetry-and-medical-surgical-units
#18
Elizabeth Schenk, Ruth Schleyer, Cami R Jones, Sarah Fincham, Kenn B Daratha, Karen A Monsen
AIM: This study examined nurses' work, comparing nursing interventions and locations across three units in a United States hospital using Omaha System standardized terminology as the organizing framework. BACKGROUND: The differences in nurses' acute-care work across unit types are not well understood. Prior investigators have used time-motion methodologies; few have compared differences across units, nor used standardized terminology. METHODS: Nurse-observers recorded locations and interventions of nurses on three acute-care units using hand-held devices and web-based TimeCaT(™) software...
August 29, 2017: Journal of Nursing Management
https://www.readbyqxmd.com/read/28852789/a-multi-center-prospective-cohort-study-of-patient-transfers-from-the-intensive-care-unit-to-the-hospital-ward
#19
Henry T Stelfox, Jeanna Parsons Leigh, Peter M Dodek, Alexis F Turgeon, Alan J Forster, Francois Lamontagne, Rob A Fowler, Andrea Soo, Sean M Bagshaw
PURPOSE: To provide a 360-degree description of ICU-to-ward transfers. METHODS: Prospective cohort study of 451 adults transferred from a medical-surgical ICU to a hospital ward in 10 Canadian hospitals July 2014-January 2016. Transfer processes documented in the medical record. Patient (or delegate) and provider (ICU/ward physician/nurse) perspectives solicited by survey 24-72 h after transfer. RESULTS: Medical records (100%) and survey responses (ICU physicians-80%, ICU nurses-80%, ward physicians-46%, ward nurses-64%, patients-74%) were available for most transfers...
August 29, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28843757/changing-operating-room-culture-implementation-of-a-post-operative-debrief-and-improved-safety-culture
#20
Stephen T Magill, Doris D Wang, W Caleb Rutledge, Darryl Lau, Mitchel S Berger, Sujatha Sankaran, Catherine Y Lau, Sarah G Imershein
BACKGROUND: Patient safety is foundational to neurosurgical care. Post-procedural "debrief" checklists have been proposed to improve patient safety, but there is limited data about their use in neurosurgery. Here, we implemented an initiative to routinely perform post-operative debriefs and evaluated the impact of debriefing on operating room (OR) safety culture. METHODS: A 10-question safety attitude questionnaire (SAQ) was sent to neurosurgical operating room staff at a major academic medical center before and 18-months after implementation of a post-operative debriefing initiative...
August 23, 2017: World Neurosurgery
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