Current Issue : October - December Volume : 2011 Issue Number : 1 Articles : 7 Articles
We aimed to develop a new scale for evaluating risks and preventive measures for in-hospital falls of newborn infants, from admission to discharge of the expectant mother. Our study was prepared in accordance with Failure Modes and Effects Analysis criteria. The risks and preventive measures for in-hospital falls of newborns were determined. Risk Priority Numbers (RPNs) were determined by multiplication of the scores of severity, probability of occurrence, and probability of detection. Analyses showed that risks having the highest RPNs were the mother with epidural anesthesia (RPN: 350 point), holding of the baby at the moment of delivery (RPN: 240), and transportation of baby right after delivery (RPN: 240). A reduction was detected in all RPNs after the application of preventive measures. Our risk model can function as a guide for obstetric clinics that need to form strategies to prevent newborn falls....
Background: Lifestyle risk factors, in particular smoking, nutrition, alcohol consumption and physical inactivity (SNAP) are the main behavioural risk factors for chronic disease. Primary health care (PHC) has been shown to be an effective setting to address lifestyle risk factors at the individual level. However much of the focus of research to date has been in general practice. Relatively little attention has been paid to the role of nurses working in the PHC setting. Community health nurses are well placed to provide lifestyle intervention as they often see clients in their own homes over an extended period of time, providing the opportunity to offer intervention and enhance motivation through repeated contacts. The overall aim of this study is to evaluate the impact of a brief lifestyle intervention delivered by community nurses in routine practice on changes in clientsââ?¬â?¢ SNAP risk factors.\r\nMethods/Design: \r\nThe trial uses a quasi-experimental design involving four generalist community nursing services in NSW Australia. Services have been randomly allocated to an ââ?¬Ë?early interventionââ?¬â?¢ group or ââ?¬Ë?late interventionââ?¬â?¢ (comparison) group. ââ?¬Ë?Early interventionââ?¬â?¢ sites are provided with training and support for nurses in identifying and\r\noffering brief lifestyle intervention for clients during routine consultations. ââ?¬Ë?Late intervention siteââ?¬â?¢ provide usual care and will be offered the study intervention following the final data collection point. A total of 720 generalist community nursing clients will be recruited at the time of referral from participating sites. Data collection consists of 1) telephone surveys with clients at baseline, three months and six months to examine change in SNAP risk factors and readiness to change 2) nurse survey at baseline, six and 12 months to examine changes in nurse\r\nconfidence, attitudes and practices in the assessment and management of SNAP risk factors 3) semi-structured interviews/focus with nurses, managers and clients in ââ?¬Ë?early interventionââ?¬â?¢ sites to explore the feasibility, acceptability and sustainability of the intervention.\r\nDiscussion: \r\nThe study will provide evidence about the effectiveness and feasibility of brief lifestyle interventions delivered by generalist community nurses as part of routine practice. This will inform future community nursing practice and PHC policy....
OBJECTIVE:\r\nWe examined the association between density of healthcare providers and patient outcomes using a large nationally representative cohort of patients receiving combination antiretroviral therapy (cART) in Uganda.\r\nDESIGN:\r\nWe obtained data from The AIDS Support Organization (TASO) in Uganda. Patients 18 years of age and older who initiated cART at TASO between 2004 and 2008 contributed to this analysis. The number of healthcare providers per 100 patients, the number of patients lost to follow-up per 100 person years and number of deaths per 100 person years were calculated. Spearman correlation was used to identify associations between patient loss to follow-up and mortality with the healthcare provider-patient ratios.\r\nRESULTS: \r\nWe found no significant associations between the number of patients lost to follow-up and physicians (p?=?0.45), nurses (p?=?0.93), clinical officers (p?=?0.80), field officers (p?=?0.56), and healthcare providers overall (p?=?0.83). Similarly, no significant associations were observed between mortality and physicians (p?=?0.65), nurses (p?=?0.49), clinical officers (p?=?0.73), field officers (p?=?0.78), and healthcare providers overall (p?=?0.73).\r\nCONCLUSIONS:\r\nPatient outcomes, as measured by loss to follow-up and mortality, were not significantly associated with the number of doctors, nurses, clinical officers, field officers, or healthcare providers overall. This may suggest that that other factors, such as the presence of volunteer patient supporters or broader political or socioeconomic influences, may be more closely associated with outcomes of care among patients on cART in Uganda....
Background: \r\nBreastfeeding is considered the ideal method of infant feeding for at least the first six months of life. This study aimed to compare breastfeeding intention between Syrian and Jordanian women and determine factors associated with breastfeeding intention among pregnant women in these two countries.\r\nMethods: \r\nA cross-sectional design was used to collect data from1200 pregnant women aged 18 years and above (600 participants from each country). A self- administered questionnaire was used to collect data on socio-demographic characteristics and breastfeeding intention.\r\nResults: \r\nIntention to breastfeed was reported by 77.2% of Syrian and 76.2% of Jordanian pregnant women. There was no significant difference in intention to breastfeed between Syrian women and Jordanian women. In both countries, women with a more positive attitude to breastfeeding, women with previous breastfeeding experience and women with supportive partners were more likely to intend to breastfeed. Syrian women with a monthly family income of more than US$200, younger than 25 and primiparous or having one child were more likely to report an intention to breastfeed their infants. Jordanian women with an education level of less than high school and not living with their family-in-law were more likely to intend to breastfeed.\r\nConclusions: \r\nIn Syria and Jordan, a more positive attitude to breastfeeding, previous breastfeeding experience and\r\npresence of supportive husbands are associated with intention to breastfeed. These factors should be considered when planning programs designed to promote breastfeeding in these two countries....
Background:\r\nPain is one of the most frequent and distressing symptoms in cancer patients. For the majority of the patients, sufficient pain relief can be obtained if adequate treatment is provided. However, pain remains often undertreated due to institutional, health care professional and patient related barriers. Patients self management skills are affected by the patients� knowledge, activities and attitude to pain management. This trial protocol is aimed to test the SCION-PAIN program, a multi modular structured intervention to improve self management in\r\ncancer patients with pain.\r\nMethods:\r\n240 patients with diagnosed malignancy and pain > 3 days and average pain = 3/10 will participate in a cluster randomized trial on 18 wards in 2 German university hospitals. Patients from the intervention wards will receive, additionally to standard pain treatment, the SCION-PAIN program consisting of 3 modules: pharmacologic pain management, nonpharmacologic pain management and discharge management. The intervention will be conducted by specially trained oncology nurses and includes components of patient education, skills training and\r\ncounseling to improve self care regarding pain management beginning with admission followed by booster session every 3rd day and one follow up telephone counseling within 2 to 3 days after discharge. Patients in the control group will receive standard care. Primary endpoint is the group difference in patient related barriers to management of cancer pain (BQII), 7 days after discharge. Secondary endpoints are: pain intensity & interference, adherence, coping and HRQoL.\r\nDiscussion: \r\nThe study will determine if the acquired self management skills of the patients continue to be used after discharge from hospital. It is hypothesized that patients who receive the multi modular structured intervention will have less patient related barriers and a better self management of cancer pain....
Background: \r\nClinical depression is highly prevalent yet under-detected and under-treated in palliative care settings and is associated with a number of adverse medical and psychological outcomes for patients and their family members. This article presents a study protocol to evaluate a training intervention for non-physician\r\npalliative care staff to improve the recognition of depression and provide support for depressed patients and their family members. Details of the hypotheses and expected outcomes, study design, training program development and evaluation measures are described.\r\nMethods and Design:\r\nA randomised controlled trial will be implemented across two palliative care services to evaluate the ââ?¬Å?Training program for professional carers to recognise and manage depression in palliative care settingsââ?¬Â. Pre-, post- and three-month follow-up data will be collected to assess: the impact of the training on the\r\nknowledge, attitudes, self-efficacy and perceived barriers of palliative care staff when working with depression; referral rates for depression; and changes to staff practices. Quantitative and qualitative methods, in the form of self-report questionnaires and interviews with staff and family members, will be used to evaluate the effectiveness of the intervention.\r\nDiscussion: \r\nThis study will determine the effectiveness of an intervention that aims to respond to the urgent need for innovative programs to target depression in the palliative care setting. The expected outcome of this study is the validation of an evidence-based training program to improve staff recognition and appropriate referrals for depression, as well as improve psychosocial support for depressed patients and their family members....
Background: \r\nThe Vivian Bullwinkel Oration honours the life and work of an extraordinary nurse. Given her story and that of her World War II colleagues, the topic of nursing heroism in the 21st century could not be more germane.\r\nDiscussion: \r\nIs heroism a legitimate part of nursing, or are nurses simply ââ?¬Ë?just doing their jobââ?¬â?¢ even when facing extreme personal danger? In this paper I explore the place and relevance of heroism in contemporary nursing. I propose that nursing heroism deserves a broader appreciation and that within the term lie many hidden, ââ?¬Ë?unsungââ?¬â?¢\r\nor ââ?¬Ë?unrecordedââ?¬â?¢ heroisms. I also challenge the critiques of heroism that would condemn it as part of a ââ?¬Ë?militarisationââ?¬â?¢ of nursing. Finally, I argue that nursing needs to be more open in celebrating our heroes and the transformative power of nursing achievements.\r\nSummary: \r\nThe language of heroism may sound quaint by 21st Century standards but nursing heroism is alive and well in the best of our contemporary nursing ethos and practice....
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