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Medical Surgical Nursing

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https://www.readbyqxmd.com/read/28650682/de-escalation-training-to-medical-surgical-nurses-in-the-acute-care-setting
#1
Kimberly Lynn Ferrara, Mary Lynn Davis-Ajami, Joan Insalaco Warren, Lyn Stankiewicz Murphy
Violence is increasing on medical-surgical units as a "silent epidemic." This quality improvement project employs a small non-experimental, single-group, pre- and post-test design (N = 11) to determine the effectiveness of de-escalation training on medical-surgical nurses' confidence levels when dealing with agitated patients. Regardless of age, education, or years of experience, scores improved for each question on Thackrey's (1987) Confidence in Coping with Patient Aggression Instrument after implementing Ten Domains of De-escalation by Richmond et al...
June 26, 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28650412/pressure-injury-knowledge-in-critical-care-nurses
#2
Donna M Miller, Lisa Neelon, Kathleen Kish-Smith, Laura Whitney, Christopher J Burant
PURPOSE: The purpose of this study was to identify pressure injury knowledge in critical care nurses related to prevention and staging following multimodal education initiatives. DESIGN: Postintervention descriptive study. SETTING AND SAMPLE: The sample comprised 32 RNs employed in medical intensive care/coronary intensive care or surgical intensive care units. The study setting was a 237-bed Veterans Affairs acute care hospital in the Midwestern United States...
June 21, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28643721/surgical-treatment-of-metarhizium-anisopliae-sclerokeratitis-and-endophthalmitis
#3
Dan Derhy, Arnaud Sauer, Marcela Sabou, Jonathan Letsch, Ermanno Candolfi, Valérie Letscher-Bru, Tristan Bourcier
A 55-year-old nurse was referred with a 5-month history of right eye corneal abscess. The initial injury occurred when doing lawn work. The infection worsened despite multiple antibiotic, antiviral, and steroid treatments. Visual acuity was limited to hand motion. On examination, there was keratitis, ocular hypertension, and a secondary cataract. Corneal scrapings grew a filamentous fungus, identified as Metarhizium anisopliae (MA). Despite intensive antifungal treatment with topical, intravitreous, and systemic voriconazole, purulent corneal melting and scleritis with endophthalmitis rapidly appeared...
June 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28643577/an-assessment-of-advance-relatives-approach-for-brain-death-organ-donation
#4
Carine Michaut, Antoine Baumann, Hélène Gregoire, Corinne Laviale, Gérard Audibert, Xavier Ducrocq
BACKGROUND: Advance announcement of forthcoming brain death has developed to enable intensivists and organ procurement organisation coordinators to more appropriately, and separately from each other, explain to relatives brain death and the subsequent post-mortem organ donation opportunity. Research aim: The aim was to assess how potentially involved healthcare professionals perceived ethical issues surrounding the strategy of advance approach. RESEARCH DESIGN: A multi-centre opinion survey using an anonymous self-administered questionnaire was conducted in the six-member hospitals of the publicly funded East of France regional organ and tissue procurement network called 'Prélor'...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28642125/safety-and-efficacy-of-dual-lead-thalamic-deep-brain-stimulation-for-patients-with-treatment-refractory-multiple-sclerosis-tremor-a-single-centre-randomised-single-blind-pilot-trial
#5
Seth F Oliveria, Ramon L Rodriguez, Dawn Bowers, Daniel Kantor, Justin D Hilliard, Erin H Monari, Bonnie M Scott, Michael S Okun, Kelly D Foote
BACKGROUND: Efficacy in previous studies of surgical treatments of refractory multiple sclerosis tremor using lesioning or deep brain stimulation (DBS) has been variable. The aim of this study was to investigate the safety and efficacy of dual-lead thalamic DBS (one targeting the ventralis intermedius-ventralis oralis posterior nucleus border [the VIM lead] and one targeting the ventralis oralis anterior-ventralis oralis posterior border [the VO lead]) for the treatment of multiple sclerosis tremor...
June 19, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28632535/perioperative-surgical-home-evaluation-of-a-new-protocol-focused-on-a-multidisciplinary-approach-to-manage-children-undergoing-posterior-spinal-fusion-operation
#6
Eugene Kim, Brian Lee, Giovanni Cucchiaro
BACKGROUND: The concept of Perioperative Surgical Home has been gaining significant attention in surgical centers. This model is delivering and improving coordinated care in a cost-effective manner to patients undergoing surgical procedures. It starts with the decision for surgical intervention, continues to the intraoperative and postoperative periods, and follows into long-term recovery. Constant re-evaluation of outcomes and modifications of delivery provides a feedback loop for improvement...
June 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28628072/retention-of-content-utilizing-a-flipped-classroom-approach
#7
Bobbi Shatto, Kristine LʼEcuyer, Jerod Quinn
The flipped classroom experience promotes retention and accountability for learning. The authors report their evaluation of a flipped classroom for accelerated second-degree nursing students during their primary medical-surgical nursing course. Standardized HESI® scores were compared between a group of students who experienced the flipped classroom and a previous group who had traditional teaching methods. Short- and long-term retention was measured using standardized exams 3 months and 12 months following the course...
July 2017: Nursing Education Perspectives
https://www.readbyqxmd.com/read/28618123/-pain-relieved-but-still-struggling-critically-ill-patients-experiences-of-pain-and-other-discomforts-during-analgosedation
#8
Helene Berntzen, Ida Torunn Bjørk, Hilde Wøien
AIM & OBJECTIVE: To explore how critically ill patients treated according to a strategy of analgosedation experience and handle pain, other discomforts, and wakefulness. BACKGROUND: Patients experience both pain and discomfort while in the intensive care unit (ICU). International guidelines recommend focused pain treatment and light sedation. An analgosedation protocol favoring pain management, light sedation and early mobilization was implemented in our university hospital medical and surgical ICU in Norway in 2014...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28608018/surgical-human-resources-according-to-types-of-health-care-facility-an-assessment-in-low-and-middle-income-countries
#9
Shirwa Sheik Ali, Zahra Jaffry, Meena N Cherian, Teena Kunjumen, Annette M Nkwowane, Andrew J M Leather, Hernan Montenegro Von Muhlenbrock, Edward Kelley, James Campbell
BACKGROUND: A robust health care system providing safe surgical care to a population can only be achieved in conjunction with access to competent surgical personnel. It has been reported that 5 billion people do not have access to safe, affordable surgical and anaesthesia care when needed. This study aims to fill the existing gap in evidence by quantifying shortfalls in trained personnel delivering safe surgical and anaesthetic care in low- and middle-income countries (LMICs) according to the type of health care facility...
June 12, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28607678/choosing-wisely-a-quality-improvement-initiative-to-decrease-unnecessary-preoperative-testing
#10
John Matulis, Stephen Liu, John Mecchella, Frederick North, Alison Holmes
Dartmouth-Hitchcock Medical Center is a rural, academic medical center in the northeastern United States; its General Internal Medicine (GIM) division performs about 900 low and intermediate surgical risk preoperative evaluations annually. Routine preoperative testing in these evaluations is widely considered a low-value service. Our baseline data sample showed unnecessary testing rates of approximately 36%. A multi-disciplinary team used a micro-systems approach to analyze the existing process and formulate a rapid cycle improvement strategy...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28601334/variation-in-readmission-expenditures-after-high-risk-surgery
#11
Bruce L Jacobs, Chang He, Benjamin Y Li, Alex Helfand, Naveen Krishnan, Tudor Borza, Amir A Ghaferi, Brent K Hollenbeck, Jonathan E Helm, Mariel S Lavieri, Ted A Skolarus
BACKGROUND: The Hospital Readmissions Reduction Program reduces payments to hospitals with excess readmissions for three common medical conditions and recently extended its readmission program to surgical patients. We sought to investigate readmission intensity as measured by readmission cost for high-risk surgeries and examine predictors of higher readmission costs. MATERIALS AND METHODS: We used the Healthcare Cost and Utilization Project's State Inpatient Database to perform a retrospective cohort study of patients undergoing major chest (aortic valve replacement, coronary artery bypass grafting, lung resection) and major abdominal (abdominal aortic aneurysm repair [open approach], cystectomy, esophagectomy, pancreatectomy) surgery in 2009 and 2010...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28600757/obstetric-fistula-in-niger-6-month-postoperative-follow-up-of-384-patients-from-the-danja-fistula-center
#12
Itengre Ouedraogo, Christopher Payne, Rahel Nardos, Avril J Adelman, L Lewis Wall
INTRODUCTION AND HYPOTHESIS: The impoverished West African country of Niger has high rates of obstetric fistula. We report a 6-month postoperative follow-up of 384 patients from the Danja Fistula Center and assess factors associated with operative success or failure. METHODS: The medical records of 384 women who had completed a 6-month follow-up after fistula surgery were reviewed. Cases were categorized as "easy," "of intermediate complexity," or "difficult" based on a preoperative points system...
June 9, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28585054/the-effects-of-person-centered-or-other-supportive-interventions-in-older-women-with-osteoporotic-vertebral-compression-fractures-a-systematic-review-of-the-literature
#13
REVIEW
H K Svensson, L -E Olsson, T Hansson, J Karlsson, E Hansson-Olofsson
Vertebral compression fracture (VCF) is a common fragility fracture and the starting point of a lasting, painful, disabling condition. The aim was to summarize evidence of person-centered/non-medical interventions supporting women with VCF. Results show small numbers of studies with only probable effect on function, pain, QoL, fear of falling, and psychological symptoms. The vertebral compression fracture (VCF) caused by osteoporosis is the third most common fragility fracture worldwide. Previously, it was believed that the pain caused by VCF was self-subsiding within weeks or a few months post-fracture...
June 6, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28584544/contextual-facilitators-and-maintaining-of-compassion-based-care-an-ethnographic-study
#14
Sima Babaei, Fariba Taleghani, Mahmoud Keyvanara
BACKGROUND: Compassion is an important part of nursing. It fosters better relationships between nurses and their patients. Moreover, it gives patients more confidence in the care they receive. Determining facilitators of compassion are essential to holistic care. The purpose of this study was to explore these facilitators. MATERIALS AND METHODS: This ethnographic study was conducted in 2014-2015 with 20 nurses, 12 patients, and 4 family members in the medical and surgical wards...
March 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28570718/free-flap-reconstruction-monitoring-techniques-and-frequency-in-the-era-of-restricted-resident-work-hours
#15
Urjeet A Patel, David Hernandez, Yelizaveta Shnayder, Mark K Wax, Matthew M Hanasono, Joshua Hornig, Tamer A Ghanem, Matthew Old, Ryan S Jackson, Levi G Ledgerwood, Patrik Pipkorn, Lawrence Lin, Adrian Ong, Joshua B Greene, James Bekeny, Yin Yiu, Salem Noureldine, David X Li, Joel Fontanarosa, Evan Greenbaum, Jeremy M Richmon
Importance: Free flap reconstruction of the head and neck is routinely performed with success rates around 94% to 99% at most institutions. Despite experience and meticulous technique, there is a small but recognized risk of partial or total flap loss in the postoperative setting. Historically, most microvascular surgeons involve resident house staff in flap monitoring protocols, and programs relied heavily on in-house resident physicians to assure timely intervention for compromised flaps...
June 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28567167/nurse-competence-on-physiologic-monitors-use-toward-eliminating-alarm-fatigue-in-intensive-care-units
#16
Azizeh K Sowan, Ana G Vera, Elma I Fonseca, Charles C Reed, Albert F Tarriela, Andrea E Berndt
BACKGROUND: Studies on nurse competence on alarm management are a few and tend to be focused on limited skills. In response to Phase II of implementing the National Patient Safety Goal on clinical alarm systems safety, this study assessed nurses' perceived competence on physiologic monitors use in intensive care units (ICUs) and developed and validated a tool for this purpose. METHODS: This descriptive study took place in a Magnet hospital in a Southwestern state of the U...
2017: Open Medical Informatics Journal
https://www.readbyqxmd.com/read/28560917/caring-for-patients-with-parkinson-s-disease-in-general-hospital-settings
#17
Vicky Queen
Parkinson's disease (PD) is a common progressive neurological condition. There are 127,000 people with the disease in the UK, that is, one in every 500 of the population. In 2014-15 there were 14,000 hospital admissions of people with PD in England. However, PD is often not the primary cause of admission. Urinary tract infections and pneumonia, for example, are frequent causes of hospital admission for people with PD. Therefore, nurses on general medical and surgical wards will often care for people with PD...
May 31, 2017: Nursing Older People
https://www.readbyqxmd.com/read/28549765/improving-patient-centered-transitional-care-after-complex-abdominal-surgery
#18
Alexandra W Acher, Stephanie A Campbell-Flohr, Maria Brenny-Fitzpatrick, Kristine M Leahy-Gross, Sara Fernandes-Taylor, Alexander V Fisher, Suresh Agarwal, Amy J Kind, Caprice C Greenberg, Pascale Carayon, Sharon M Weber
BACKGROUND: Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. STUDY DESIGN: The intervention includes in-person enrollment of patients...
May 18, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28538983/assocation-of-a-surgical-task-during-training-with-team-skill-acquisition-among-surgical-residents-the-missing-piece-in-multidisciplinary-team-training
#19
Jessica L Sparks, Dustin L Crouch, Kathryn Sobba, Douglas Evans, Jing Zhang, James E Johnson, Ian Saunders, John Thomas, Sarah Bodin, Ashley Tonidandel, Jeff Carter, Carl Westcott, R Shayn Martin, Amy Hildreth
Importance: The human patient simulators that are currently used in multidisciplinary operating room team training scenarios cannot simulate surgical tasks because they lack a realistic surgical anatomy. Thus, they eliminate the surgeon's primary task in the operating room. The surgical trainee is presented with a significant barrier when he or she attempts to suspend disbelief and engage in the scenario. Objective: To develop and test a simulation-based operating room team training strategy that challenges the communication abilities and teamwork competencies of surgeons while they are engaged in realistic operative maneuvers...
May 24, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28532515/what-do-we-know-about-assessing-healthcare-students-and-professionals-knowledge-attitude-and-practice-regarding-female-genital-mutilation-a-systematic-review
#20
REVIEW
Jasmine Abdulcadir, Lale Say, Christina Pallitto
INTRODUCTION: Improving healthcare providers' capacities of prevention and treatment of female genital mutilation (FGM) is important given the fact that 200 million women and girls globally are living with FGM. However, training programs are lacking and often not evaluated. Validated and standardized tools to assess providers' knowledge, attitude and practice (KAP) regarding FGM are lacking. Therefore, little evidence exists on the impact of training efforts on healthcare providers' KAP on FGM...
May 22, 2017: Reproductive Health
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