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https://www.readbyqxmd.com/read/28610531/keep-handovers-in-the-office
#1
Louise Richards
Patient information is meant to be confidential. How is that possible when you give a bedside handover with other patients in the room (Readers' Panel, June 7). Handovers should be done in the office, followed by a walk around to introduce yourself as the nurse taking over the care, and to check on any infusions.
June 14, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28605929/tissue-necrosis-following-extravasation-of-acyclovir-in-an-adolescent-a-case-report
#2
Charalambos Neocleous, Eleni Andonopoulou, Alkistis Adramerina, Antigoni Pegkou, Olga Savelieva, Petroula Georgiadou, Ioannis Drikos
OBJECTIVE: Extravasation of intravenously infused vesicant solutions is a common problem in medical practice, which can lead to severe and progressive tissue dysfunction, ranging from persistent tissue oedema and fibrosis to delayed tissue necrosis. Acyclovir is a known vesicant medication administrated in paediatric patients, which appears to irritate venous and soft tissue if extravasated. CASE REPORT: We present the first case involving the extravasation of intravenously infused acyclovir in a female adolescent patient, which caused tissue necrosis and left behind a residual scar lesion...
May 2017: Acta Medica Academica
https://www.readbyqxmd.com/read/28577412/postmortem-computed-tomography-evaluation-of-fatal-gas-embolism-due-to-connection-of-an-intravenous-cannula-to-an-oxygen-supply
#3
Yoichiro Takahashi, Rie Sano, Akiyuki Yasuda, Eri Kuboya, Keiko Takahashi, Rieko Kubo, Yoshihiko Kominato, Hiroyuki Takei, Susumu Kobayashi, Takehiro Shimada, Sachiko Awata, Hiroyuki Tokue, Satoshi Hirasawa
An 84-year-old man who had suffered from chronic obstructive pulmonary disease accompanied by moderate pneumonia as well as gastric cancer with liver metastasis was found dead by a nurse, who noticed that the patient's intravenous catheter in the left forearm had been erroneously connected to an oxygen supply in his hospital room, leading to infusion of oxygen into a vein. Postmortem CT scanning demonstrated multiple accumulations of gas in the pulmonary artery, the right atrium and ventricle, as well as the left subclavian and brachiocephalic veins, corresponding to the route that the infused gas would have taken to the heart and pulmonary artery...
May 26, 2017: Legal Medicine
https://www.readbyqxmd.com/read/28568962/rhetoric-versus-reality-the-role-of-research-in-deconstructing-concepts-of-caring
#4
Dawn Freshwater, Jane Cahill, Philip Esterhuizen, Tessa Muncey, Helen Smith
Our aim was to employ a critical analytic lens to explicate the role of nursing research in supporting the notion of caring realities. To do this, we used case exemplars to illustrate the infusion of such discourses. The first exemplar examines the fundamental concept of caring: using Florence Nightingale's Notes on Nursing, the case study surfaces caring as originally grounded in ritualized practice and subsequently describes its transmutation, via competing discourses, to a more holistic concept. It is argued that in the many and varied attempts to define the dynamic concept of care, caring has now become paradoxically, a more fragmented concept despite attempts to render it more holistic and inclusive...
May 31, 2017: Nursing Philosophy: An International Journal for Healthcare Professionals
https://www.readbyqxmd.com/read/28566361/effectiveness-of-%C3%AE-2agonists-for-sedation-in-paediatric-critical-care-study-protocol-for-a-retrospective-cohort-observational-study
#5
John C Hayden, Ian Dawkins, Cormac Breatnach, Finbarr P Leacy, June Foxton, Martina Healy, Gráinne Cousins, Paul J Gallagher, Dermot R Doherty
INTRODUCTION: Mechanically ventilated children in paediatric intensive care units are commonly administered analgesics and sedative agents to minimise pain and distress and facilitate cooperation with medical interventions. Opioids and benzodiazepines are the most common analgesic and sedative agents but have safety concerns. The α2 agonists clonidine and dexmedetomidine are alternative sedatives in use despite neither having robust evidence to support their use. Studies evaluating effectiveness of α2 agonists to date have not focused on sedation-based outcomes instead focusing on opioid-sparing properties and ventilation outcomes...
May 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28562809/use-of-technologies-in-intravenous-therapy-contributions-to-a-safer-practice
#6
Ana Paula Amorim Moreira, Cristina Lavoyer Escudeiro, Bárbara Pompeu Christovam, Zenith Rosa Silvino, Márglory Fraga de Carvalho, Roberto Carlos Lyra da Silva
Objectives: To identify what are the difficulties of the nursing staff in the management of technologies during intravenous therapy (IVT) and discuss the difficulties identified under the perspective of patient's safety. Method: Descriptive study of qualitative approach with data collected by semi-structured interview and analyzed by the Alceste software. Results: The greatest difficulty of cognitive and technical emphasis was the lack of training; and regarding administrative emphasis, the greatest difficulty was the lack of material and human resources...
May 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28554241/interdisciplinary-implementation-of-tacrolimus-intravenous-standard-concentration-in-hematopoietic-stem-cell-transplantation-recipients
#7
Brandon R Shank, Melissa Deaver, Angela Baker, Alan L Myers, Yan-Ping Zhang, Brent Anderegg, Roland Bassett, Michael Westmoreland
Purpose Reduction in waste of intravenous (IV) tacrolimus, an immunosuppressant used to prevent graft-versus-host disease in allogeneic hematopoietic stem cell transplantation recipients, was evaluated after standardizing the concentration. Methods A single-center, retrospective cohort study at a large academic comprehensive cancer center was performed comparing patient-specific intravenous tacrolimus doses (tacrolimus doses in 50, 100, or 250 mL of normal saline based on manufacturer's recommended concentration) to tacrolimus intravenous standard concentration (tacrolimus 1 mg in 250 mL of normal saline) continuous intravenous infusion titrated to prescribed dose...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28537773/a-new-generation-of-comfort-care-order-sets-aligning-protocols-with-current-principles
#8
Melissa A Bender, Caroline Hurd, Nicole Solvang, Kathy Colagrossi, Diane Matsuwaka, J Randall Curtis
BACKGROUND: There are few published comfort care order sets for end-of-life symptom management, contributing to variability in treatment of common symptoms. At our academic medical centers, we have observed that rapid titration of opioid infusions using our original comfort care order set's titration algorithm causes increased discomfort from opioid toxicity. OBJECTIVE: The aim of this study was to describe the process and outcomes of a multiyear revision of a standardized comfort care order set for clinicians to treat end-of-life symptoms in hospitalized patients...
May 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28522914/one-year-experience-with-computer-assisted-propofol-sedation-for-colonoscopy
#9
Otto S Lin, Danielle La Selva, Richard A Kozarek, Deborah Tombs, Wade Weigel, Ryan Beecher, Johannes Koch, Susan McCormick, Michael Chiorean, Fred Drennan, Michael Gluck, Nanda Venu, Michael Larsen, Andrew Ross
AIM: To report our one-year experience with computer assisted propofol sedation (CAPS) for colonoscopy as the first United States Medical Center to adopt CAPS technology for routine clinical use. METHODS: Between September 2014 and August 2015, 2677 patients underwent elective outpatient colonoscopy with CAPS at our center. All colonoscopies were performed by 1 of 17 gastroenterologists certified in the use of the CAPS system, with the assistance of a specially trained nurse...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28498636/study-protocol-evaluating-the-use-of-bowel-stimulation-before-loop-ileostomy-closure-to-reduce-postoperative-ileus-a-multicenter-randomized-controlled-trial
#10
Richard Garfinkle, Nora Trabulsi, Nancy Morin, Terry Phang, Sender Liberman, Liane Feldman, Gerald Fried, Marylise Boutros
AIM: Postoperative ileus is the most commonly observed morbidity following ileostomy closure. Studies have demonstrated that the defunctionalized bowel of a loop ileostomy undergoes a series of functional and structural changes, such as atrophy of the intestinal villi and muscular layers, which may contribute to ileus. A single-center study in Spain demonstrated that preoperative bowel stimulation via the distal limb of the loop ileostomy decreased postoperative ileus, length of stay, and time to gastrointestinal function...
May 12, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28494173/suicide-attempt-with-acetonitrile-ingestion-in-a-nursing-mother
#11
Eduardo Mello De Capitani, Carla Fernanda Borrasca-Fernandes, Maíra Branco Pimenta, Camila Carbone Prado, Paula Christiane Soubhia, Rafael Lanaro, Sueli Mello Moreira, Rafael Linden, Helena Valle Nóbrega, Fábio Bucaretchi, José Luiz Costa
CONTEXT: Acetonitrile (ACN) is a solvent rapidly absorbed through lungs and intestinal tract, and is slowly metabolized to cyanide (CN) by enzymatic processes mediated by CYP2E1. OBJECTIVE: To describe the clinical and laboratory evolution, ACN elimination half-life, and its presence in breast milk in a nursing mother who attempted suicide. CASE DETAILS: A 25-year-old 2-month nursing mother ingested an estimated dose of 2.1 g/kg of ACN. Blood and urine samples were collected 24 h later for ACN, CN and thiocyanate analysis, and 12...
May 11, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28488361/clonidine-for-sedation-and-analgesia-for-neonates-receiving-mechanical-ventilation
#12
REVIEW
Olga Romantsik, Maria Grazia Calevo, Elisabeth Norman, Matteo Bruschettini
BACKGROUND: Although routine administration of pharmacologic sedation or analgesia during mechanical ventilation in preterm neonates is not recommended, its use in clinical practice remains common. Alpha-2 agonists, mainly clonidine and dexmedetomidine, are used as adjunctive (or alternative) sedative agents alongside opioids and benzodiazepines. Clonidine has not been systematically assessed for use in neonatal sedation during ventilation. OBJECTIVES: To assess whether clonidine administered to term and preterm newborn infants receiving mechanical ventilation reduces morbidity and mortality rates...
May 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28471928/complication-rates-of-3-hypertonic-saline-infusion-through-peripheral-intravenous-access
#13
Claudia Andira Perez, Stephen A Figueroa
INTRODUCTION: Hyperosmolar therapy with hypertonic saline (HTS) is a cornerstone in the management of intracranial hypertension and hyponatremia in the neurological intensive care unit. Theoretical safety concerns remain for infiltration, thrombophlebitis, tissue ischemia, and venous thrombosis associated with continuous 3% HTS administered via peripheral intravenous (pIV) catheters. It is common practice at many institutions to allow only central venous catheter infusion of 3% HTS. METHODS: Hospital policy was changed to allow the administration of 3% HTS via 16- to 20-gauge pIVs to a maximum infusion rate of 50 mL/h in patients without central venous access...
June 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28469890/hypokalaemia-addressing-human-factors-and-improving-education-around-prescription-and-administration-of-intravenous-iv-potassium-infusion-in-trauma-and-orthopaedics
#14
Vanushia Thirumal, Gavin Love
A high incidence of hypokalaemia was noted in Trauma and Orthopaedics of Ninewells Hospital. We sought to establish the reason behind this and implemented three PDSA cycles via questionnaires to 30 ward staff, both doctors and nurses over a 1 week period in December, February and July 2016. Key baseline measures include availability of IV fluids with 40mmol potassium on the wards, confidence prescribing or administering IV fluids with 40mmol potassium, necessity for cardiac monitoring during slow IV potassium replacement and recognition of confusion and learning need in this area...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28460699/case-study-of-high-dose-ketamine-for-treatment-of-complex-regional-pain-syndrome-in-the-pediatric-intensive-care-unit
#15
REVIEW
Tracy Ann Pasek, Kelli Crowley, Catherine Campese, Rachel Lauer, Charles Yang
Complex regional pain syndrome (CRPS) is a life-altering and debilitating chronic pain condition. The authors are presenting a case study of a female who received high-dose ketamine for the management of her CRPS. The innovative treatment lies not only within the pharmacologic management of her pain, but also in the fact that she was the first patient to be admitted to our pediatric intensive care unit solely for pain control. The primary component of the pharmacotherapy treatment strategy plan was escalating-dose ketamine infusion via patient-controlled-analgesia approved by the pharmacy and therapeutics committee guided therapy for this patient...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28445171/identification-of-depressive-signs-in-patients-and-their-family-members-during-ipad-based-audiovisual-sessions
#16
Carol E Smith, Marilyn Werkowitch, Donna Macan Yadrich, Noreen Thompson, Eve-Lynn Nelson
Home parenteral nutrition requires a daily life-sustaining intravenous infusion over 12 hours. The daily intravenous infusion home care procedures are stringent, time-consuming tasks for patients and family caregivers who often experience depression. The purposes of this study were (1) to assess home parenteral nutrition patients and caregivers for depression and (2) to assess whether depressive signs can be seen during audiovisual discussion sessions using an Apple iPad Mini. In a clinical trial (N = 126), a subsample of 21 participants (16...
April 25, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28402925/time-delays-associated-with-vasoactive-medication-preparation-and-delivery-in-simulated-patients-at-risk-of-cardiac-arrest
#17
P G Brindley, D O'Dochartaigh, C Volney, S Ryan, M J Douma
PURPOSE: To compare, quantify, and describe the time-delays associated with four common methods of adrenaline administration in the simulated setting of impending cardiac arrest. METHODS: Using sham medication and a high-fidelity simulator, experienced Nurses prepared, then delivered, adrenaline by: i) bolus, ii) lower-concentration infusion iii) higher-concentration infusion, and iv) higher-concentration infusion plus carrier-line. We recorded medication preparation and delivery time, plus administration errors and self-reported competence...
April 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28387946/three-sides-to-a-story-child-parent-and-nurse-perspectives-on-the-child-s-experience-during-hematopoietic-stem-cell-transplantation
#18
Christina K Ullrich, Angie Mae Rodday, Kristin M Bingen, Mary Jo Kupst, Sunita K Patel, Karen L Syrjala, Lynnette L Harris, Christopher J Recklitis, Grace Chang, Eva C Guinan, Norma Terrin, Hocine Tighiouart, Sean Phipps, Susan K Parsons
BACKGROUND: The experience of children undergoing hematopoietic stem cell transplantation (HSCT), including the ways in which different participants (ie, children, parents, and nurses) contribute to the overall picture of a child's experience, is poorly characterized. This study evaluated parent, child, and nurse perspectives on the experience of children during HSCT and factors contributing to interrater differences. METHODS: Participants were enrolled in a multicenter, prospective study evaluating child and parent health-related quality of life over the year after HSCT...
April 7, 2017: Cancer
https://www.readbyqxmd.com/read/28375083/the-curative-effect-analysis-and-nursing-measures-of-the-transvaginal-myomectomy-and-transabdominal-myomectomy
#19
Lingping Meng, Wanxia Li
To analyze the curative effects of the transvaginal myomectomy (TVM) and the traditional transabdominal myomectomy (TAM). The group with traditional TAM received routine preoperative nursing guidance and postoperative care. While the group with TVM received preoperative strengthened psychological care, vaginal preparation and postoperative strengthened vagina nursing, paying attention to the prevention and treatment of complications, and maintaining effective pelvic draining and other nursing measures. After that, the statistical processing and analysis were used to compared the intraoperative blood loss, operating time, postoperative infusion time, hospitalization time, postoperative eating, postoperative ambulation, the usage rate of postoperative analgesic, postoperative morbidity and postoperative complications between the two groups Comparison between TVM group and TAM group showed that the difference of the operating time, postoperative infusion time, hospitalization time, postoperative eating, postoperative ambulation, the usage rate of postoperative analgesic, postoperative morbidity and postoperative complications between the two groups were statistically significant (P<0...
November 2016: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28345825/comparison-of-hypersensitivity-reactions-to-carboplatin-retreatment-in-gynecologic-cancer-patients-between-one-and-two-hour-infusions-a-randomized-trial-study
#20
Weerawich Pornwattanakrilert, Prapaporn Suprasert
Objective: To compare the incidence rate of carboplatin hypersensitivity reactions (HSRs) in gynecologic cancer patients receiving one-hour or two-hour carboplatin retreatment infusions. Setting: A Prospective Randomized Controlled Trial. Methods: Recurrent gynecologic cancer patients 25 to 80-years of age who were scheduled to receive carboplatin retreatment after previously receiving at least six cycles of carboplatin without a history of platinum allergy were invited to enroll. They were randomized to receive either a one-hour or two-hour carboplatin infusion in each cycle...
February 1, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
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