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https://www.readbyqxmd.com/read/27926687/an-initiative-to-standardize-the-identification-of-and-acute-response-to-postoperative-lower-extremity-neurological-deficits-effects-on-provider-knowledge-confidence-and-communication-skills
#1
Peter B Derman, Sravisht Iyer, Matthew Garner, Steven Orr, Karla J Felix, Allison Goldberg, Titilayo Ologhobo, Minlun Wu, Laura Robbins, Charles Cornell
BACKGROUND: Although relatively uncommon, neurological deficits following hip and knee arthroplasty can have permanent and debilitating consequences. This study was conducted to quantify the effectiveness of an educational curriculum aimed at standardizing the identification of and acute response to postoperative neurological deficits in the inpatient setting, specifically with respect to improvements in clinician knowledge, confidence levels, and communication skills. METHODS: A multidisciplinary committee at a single, high-volume academic institution created an algorithm delineating the appropriate clinical actions and escalation procedures in the setting of a postoperative neurological deficit for each clinical practitioner involved in care for patients who undergo arthroplasty...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27925089/nurse-care-practices-in-the-family-health-strategy
#2
Flavia Pedro Dos Anjos Santos, Sonia Acioli, Vanda Palmarella Rodrigues, Juliana Costa Machado, Moema Santos Souza, Tatiana Almeida Couto
Objective: to analyze the practices of care of nurses working in teams of the family health strategy, from the perspective of users. Method: qualitative research conducted with 34 registered users in seven family health units of a municipality of Bahia from June to December 2014. The results were organized by the technique of content analysis. Results: users showed satisfaction with the nurse care due to listening, warmth and resolution of their health needs, despite the emphasis on procedures and programs targeted to populational groups...
November 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27925078/factors-associated-with-the-occurrence-of-adverse-events-in-critical-elderly-patients
#3
Maria Cecilia Toffoletto, Ricardo Luis Barbosa, Rafaela Andolhe, Elaine Machado de Oliveira, Adriana Janzantte Ducci, Katia Grillo Padilha
Objective: to identify the factors associated with the occurrence of adverse events in critical elderly patients admitted to intensive care unit according to demographic and clinical characteristics. Method: a retrospective cohort study was conducted in nine units of a teaching hospital. Data were collected from medical records and from monitoring of nursing shift change. We used the t-test/Mann-Whitney, chi-square and logistic regression to test associations. Significance level of 5% was used...
November 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27924674/work-load-and-management-in-the-delivery-room-changing-the-direction-of-healthcare-policy
#4
Gianfranco Sfregola, Antonio Simone Laganà, Roberta Granese, Pamela Sfregola, Angela Lopinto, Onofrio Triolo
Nurse staffing, increased workload and unstable nursing unit environments are linked to negative patient outcomes including falls and medication errors on medical/surgical units. Considering this evidence, the aim of our study was to overview midwives' workload and work setting. We created a questionnaire and performed an online survey. We obtained information about the type and level of hospital, workload, the use of standardised procedures, reporting of sentinel and 'near-miss' events. We reported a severe understaffing in midwives' work settings and important underuse of standard protocols according to the international guidelines, especially in the South of Italy...
December 7, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27923378/congenital-cytomegalovirus-related-intestinal-malrotation-a-case-report
#5
Claudia Colomba, Mario Giuffrè, Simona La Placa, Antonio Cascio, Marcello Trizzino, Simona De Grazia, Giovanni Corsello
BACKGROUND: Cytomegalovirus is the most common cause of congenital infection in the developed countries. Gastrointestinal involvement has been extensively described in both adult and paediatric immunocompromised patients but it is infrequent in congenital or perinatal CMV infection. CASE PRESENTATION: We report on a case of coexistent congenital Cytomegalovirus infection with intestinal malrotation and positive intestinal Cytomegalovirus biopsy. At birth the neonate showed clinical and radiological evidence of intestinal obstruction...
December 7, 2016: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/27922563/-sign-here-nursing-value-and-the-process-of-informed-consent
#6
Wesley E Cook
Protecting patient autonomy is a key nursing role. The Code of Ethics (American Nurses Association, 2010), contextualizes the nurse's call to advocacy within the doctrine of informed consent. This article offers a primer on the legal, ethical, and practical aspects of procedural informed consent and examines the value of nursing's role within the process. The theory of nursing's value is sound, but the literature lacks data. Higher levels of evidence are necessary to make sound decisions about best practice for the process of informed consent...
October 2016: Plastic Surgical Nursing
https://www.readbyqxmd.com/read/27922518/hepatitis-c-point-of-care-testing-in-vulnerable-populations-a-human-factors-study
#7
Donna M Zucker, Akshaya Shanmugam
One third of all hepatitis C virus (HCV) cases in the United States are incarcerated in jails and prisons. Hepatitis C virus testing is primarily accomplished through a clinical laboratory, yet point-of-care (POC) testing is less invasive and results are available in 20 minutes compared with up to 3 weeks. The purpose of this article was to describe the findings of a collaborative project between the Colleges of Engineering and Nursing at the University of Massachusetts Amherst in executing a human factors study for HCV antibody testing and screening...
November 2016: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/27922202/current-practices-for-screening-consent-and-care-of-related-donors-in-france-haematopoietic-stem-cell-transplantation-coordinator-nurses-perceptions
#8
A Polomeni, C Bompoint, A Gomez, E Brissot, A Ruggeri, R Belhocine, M Mohty
Haematopoietic stem cell transplantation-coordinating nurses (HSCT-CNs) play an important role in informing related donors (RDs) and in organising human leucocyte antigen (HLA) tests, pre-donation workup and stem cells collection. Our pilot study aimed to explore French HSCT-CNs' perceptions of RD care issues. Twenty-nine French HSCT adult units were sent a questionnaire on the subject of donation procedures, HSCT-CNs' data and their professional experience of related donation issues. Twenty-two HSCT-CNs returned a completed questionnaire, and 90% of HSCT units were involved to some degree in both patient and donor care...
December 6, 2016: European Journal of Cancer Care
https://www.readbyqxmd.com/read/27921449/reduction-mammaplasty-with-the-modified-round-block-technique-in-chinese-patients-and-its-anatomy-study
#9
Wei Ding, Yinjia Ding, Hua Jiang
BACKGROUND: Although reduction mammaplasty is one of the most common procedures in plastic surgery, it is associated with some serious complications, especially in cases of severe hypertrophy or advanced ptosis, including necrosis of the nipple and areola, absence of normal sensation of the nipple-areolar complex, and loss of lactational function for future nursing. A thorough understanding of the breast anatomy is vital for successful reduction mammaplasty. This article describes the blood supply and innervation of the breasts, and introduces a modified round block technique for reduction mammaplasty based on this anatomy...
December 6, 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27919244/surgical-antibiotic-prophylaxis-in-children-a-mixed-method-study-on-healthcare-professionals-attitudes
#10
Angela Giusti, Stefania Spila Alegiani, Marta Luisa Ciofi Degli Atti, Sofia Colaceci, Roberto Raschetti, Pasquale Arace, Raffaele Spiazzi, Massimiliano Raponi
BACKGROUND: Qualitative and quantitative research investigating determinants of adherence to clinical guidelines (GLs) on surgical antibiotic prophylaxis (SAP) are scarce. We conducted a mixed-method study aimed at investigating barriers and at describing attitudes of healthcare professionals (HCPs) regarding SAP in three Italian children's hospitals. METHODS: The study comprised two sequential phases: 1) collection of qualitative data through focus groups; 2) conduction of a survey on HCPs attitudes towards SAP...
December 5, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27918098/functional-outcomes-after-transurethral-resection-of-the-prostate-in-nursing-home-residents
#11
Anne M Suskind, Louise C Walter, Shoujun Zhao, Emily Finlayson
OBJECTIVES: To understand outcomes of transurethral resection of the prostate (TURP) or transurethral laser incision of the prostate (TULIP) for the treatment of bladder outlet obstruction in men with high levels of functional dependence, which are poorly understood. DESIGN: Retrospective cohort study. SETTING: U.S. nursing homes (NHs). PARTICIPANTS: Male NH residents aged 65 and older who underwent TURP or TULIP in the United States between 2005 and 2008 (N = 2,869)...
December 5, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27917195/the-quality-of-rapid-hiv-testing-in-south-africa-an-assessment-of-testers-compliance
#12
Aziza Mwisongo, Karl Peltzer, Neo Mohlabane, Bomkazi Tutshana
BACKGROUND: The aim of this study was to assess the quality of rapid HIV testing in South Africa. METHOD: A two-stage sampling procedure was used to select HCT sites in eight provinces of South Africa. The study employed both semi-structured interviews with HIV testers and observation of testing sessions as a means of data collection. In total, 63 HCT sites (one HIV tester per site) were included in the survey assessing qualification, training, testing practices and attitudes towards rapid tests...
September 2016: African Health Sciences
https://www.readbyqxmd.com/read/27914750/-medical-prescription-and-informed-consent-for-the-use-of-physical-restraints-in-nursing-homes-in-the-canary-islands-spain
#13
Gabriel J Estévez-Guerra, Emilio Fariña-López, Eva Penelo
OBJECTIVE: To identify the frequency of completion of informed consent and medical prescription in the clinical records of older patients subject to physical restraint, and to analyse the association between patient characteristics and the absence of such documentation. METHODS: A cross-sectional and descriptive multicentre study with direct observation and review of clinical records was conducted in nine public nursing homes, comprising 1,058 beds. RESULTS: 274 residents were physically restrained...
November 30, 2016: Gaceta Sanitaria
https://www.readbyqxmd.com/read/27909640/treating-fasciotomy-wounds-with-negative-pressure-wound-therapy-with-instillation-and-dwell-time-npwti-d
#14
Priscilla Lee
Acute compartment syndrome (ACS) is a serious complication of lower-extremity trauma caused by accidents or post-procedure complications. ACS is characterized by increased pressure within the compartment, resulting in reduced blood flow, tissue hypoxia, and tissue necrosis. Fasciotomies to relieve pressure and debridement of necrotic tissue comprise primary treatment. My purpose is to present initial experience using negative pressure wound therapy with instillation and dwell time (NPWTi-d)* to treat fasciotomy wounds in two patients...
October 28, 2016: Curēus
https://www.readbyqxmd.com/read/27908945/norwood-procedure-for-palliation-of-hypoplastic-left-heart-syndrome-right-ventricle-to-pulmonary-artery-conduit-vs-modified-blalock-taussig-shunt
#15
Dorothy M Beke
Patients with hypoplastic left heart syndrome undergo a series of operations to separate the pulmonary and systemic circulations. The first of at least 3 operations occurs in the newborn period, with a stage I palliation. The goal of stage I palliation is to provide pulmonary blood flow and create an unobstructed systemic outflow tract. Advances in surgical techniques and intraoperative and postoperative care have helped decrease morbidity and mortality for patients with hypoplastic left heart syndrome who have the stage I Norwood operation, but the patients continue to be at increased risk for hemodynamic collapse and adverse outcomes...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27908942/the-need-for-an-effective-process-to-resolve-conflicts-over-medical-futility-a-case-study-and-analysis
#16
Jocelyn A Olmstead, Michael D Dahnke
The issue of medical futility requires a well-defined process in which both sides of the dispute can be heard and a resolution reached in a fair and ethical manner. Procedural approaches to medical futility cases provide all parties involved with a process-driven framework for resolving these disputes. Medical paternalism or the belief in the absolute rightness of the medical model will not serve to resolve these disputes. Although medical futility is first determined by medicine, in order for the determination to meet legal criteria, it must be subject to review...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27906481/experience-and-nursing-needs-of-school-age-children-undergoing-lumbar-puncture-during-the-treatment-of-acute-lymphoblastic-leukemia-a-descriptive-and-qualitative-study
#17
Anwei Xie, Yuying Shan, Mei E Niu, Yi Chen, Xiya Wang
AIMS AND OBJECTIVES: To describe experiences and nursing needs of school-age Chinese children undergoing lumbar puncture for the treatment of acute lymphoblastic leukemia (ALL). BACKGROUND: Lumbar puncture is an invasive procedure, causing psychological changes and physical discomfort in patients. In a previous study, it was proved that distraction intervention, such as music therapy, relieves pain and anxiety. There is limited evidence regarding the experience and needs of school-age children during lumbar puncture after being diagnosed with acute lymphoblastic leukemia...
December 1, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27905677/coping-and-caring-support-resources-integral-to-perioperative-nurses-during-the-process-of-organ-procurement-surgery
#18
Zaneta Smith, Gavin Leslie, Dianne Wynaden
AIM AND OBJECTIVE: This paper, discusses and explores the levels of support provided to perioperative nurses' when participating in multi-organ procurement surgery and the impact to their overall well-being. BACKGROUND: Assisting within multi-organ procurement surgical procedures has been recognised to impact on the well-being of perioperative nurses leaving little opportunity for them to recover from their participation or to seek available support resources. To date, this area has remained largely unexplored with limited evidence of how nurses manage and cope with these procedures, in addition to the support received in the workplace...
December 1, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27903757/beyond-hand-hygiene-a-qualitative-study-of-the-everyday-work-of-preventing-cross-contamination-on-hospital-wards
#19
Su-Yin Hor, Claire Hooker, Rick Iedema, Mary Wyer, Gwendolyn L Gilbert, Christine Jorm, Matthew Vincent Neil O'Sullivan
BACKGROUND: Hospital-acquired infections are the most common adverse event for inpatients worldwide. Efforts to prevent microbial cross-contamination currently focus on hand hygiene and use of personal protective equipment (PPE), with variable success. Better understanding is needed of infection prevention and control (IPC) in routine clinical practice. METHODS: We report on an interventionist video-reflexive ethnography study that explored how healthcare workers performed IPC in three wards in two hospitals in New South Wales, Australia: an intensive care unit and two general surgical wards...
November 30, 2016: BMJ Quality & Safety
https://www.readbyqxmd.com/read/27902658/understanding-negative-predictive-value-of-diagnostic-tests-used-in-clinical-practice
#20
Reba A Umberger, Linda A Hatfield, Patricia M Speck
Nurses review, evaluate, and use diagnostic test results on a routine basis. However, the skills necessary to evaluate a particular test using statistical outcome measures is often lacking. The purpose of this article is to examine and interpret the underlying principles for use of the statistical outcomes of diagnostic screening tests (sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values, with a discussion about use of SpPIn [Specificity, Positive test = rule in], and SnNOut [Sensitivity, Negative test = rule out]) in advanced nursing clinical practice...
January 2017: Dimensions of Critical Care Nursing: DCCN
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