Current Issue : April - June Volume : 2017 Issue Number : 2 Articles : 7 Articles
Assessment of level of consciousness using the Glasgow Coma Scale (GCS) is a tool requiring knowledge that is important in\ndetecting early deterioration in a patient�s level of consciousness. Critical thinking used with the skill and knowledge in assessing\nthe GCS is the foundation of all nursing practice. This study aims to explore the knowledge and competence in assessing the GCS\namong staff nurses working in the Emergency and Outpatient Departments. This is a quantitative descriptive cross-sectional study\ndesign using the GCSKnowledge Questionnaire.Convenience sampling method was used.Nurses in theseDepartmentswere asked\nto partake in the survey. Data collected was analyzed using the Statistical Package of Social Sciences (SPSS) version 20. Descriptive\nand Pearson�s chi square was used. Result showed that 55.56% of nurses had poor knowledge followed by 41.48% and 2.96% with\nsatisfactory knowledge and good knowledge, respectively. The result on the association between knowledge and education level\nshowed a significant association between the two variables (...
Immigrants from the Middle East have higher prevalence and incidence of type 2 diabetes (T2D) compared with native Swedes.\nThe aim of the study was to describe and understand health beliefs in relation to T2D as well as attitudes regarding participation in\na screening process in a local group of Assyrian immigrants living in Sweden. A qualitative and quantitative method was chosen in\nwhich 43 individuals participated in a health check-up and 13 agreed to be interviewed. Interviews were conducted, anthropometric\nmeasurements and blood tests were collected, and an oral glucose tolerance test was performed. In total, 13 of the 43 participants\nwere diagnosed with impaired glucose metabolism, 4 of these 13 had TD2. The interviewed participants perceived that screening\nwas an opportunity to discover more about their health and to care for themselves and their families. Nevertheless, they were not\nnecessarily committed to taking action as a consequence of the screening. Instead, they professed that their health was not solely\nin their own hands and that they felt safe that God would provide for them. Assyrians� background and religion affect their health\nbeliefs and willingness to participate in screening for TD2....
Background: The importance of the acute phase in hospitals has been increasing.\nWhile administering high-level critical care, the working styles of critical care nurses,\nthe types of clinical care they provide, and the way in which they prioritize tasks, remain\nunclear. Aim of this study was to elucidate the characteristic duties of critical\ncare nurses through a comparison with neurological ward nurses. Methods: We recorded\nthe duties of critical care nurses and neurology ward nurses (10 each) using a\ntime-study design. Duties were measured separately by action, classified using a classification\ntable, and differences between the two groups were compared. Results: No\ndifferences in the number of actions were observed between the two groups. The top\nfive items that required the most time for critical care nurses were, ââ?¬Å?Movementââ?¬Â,\nââ?¬Å?Administration and oxygen managementââ?¬Â, ââ?¬Å?Handover process/Doctorââ?¬â?¢s roundsââ?¬Â,\nââ?¬Å?Preparation for entry and exit management of patientsââ?¬Â, and ââ?¬Å?Bed bathing (for\nbedbound patients)ââ?¬Â. Of the 195 items, significant differences between the groups\nwere noted for 34 items, while the duties of critical care nurses were best characterized\nby bed bathing (for bedbound patients), changing position, confirmation of\ninfusion tubes, handover process/doctorââ?¬â?¢s rounds, and preparation for entry and exit\nmanagement of patients. Conclusion: A characteristic of critical care nurses is that\nthey must remain near patients and perform tasks while moving only a short distance.\nMoreover, the promotion of tasks while communicating with physicians is\npresumed to play a role in the promotion of team medicine. Furthermore, much time\nwas spent caring for patients in bed, and a lot of time was devoted to the preparation\nand finalizing of treatments and care, suggesting the possibility that more time can\nbe spent on caring for patients through a revision of duties....
Patients requiring Subacute and Complex Care services continue to challenge hospitals\nattempting to reduce inpatient stays and improve efficiency. In recent years,\nnumbers of high severity of illness patients in hospitals have increased, adding to this\nchallenge. Nurse care managers have a major responsibility for supporting the care of\nthese patients. This study described the development of services for Subacute and\nComplex Care patients in the hospitals of Syracuse, New York. These hospitals used\ntheir own resources to develop programs including high cost medications, intravenous\ntherapy, extensive wound care, and bariatric care in settings where they had not\nbeen available. In the absence of third party funding of another level of care, the hospitals\nprovided program development funds for limited time periods in order to initiate\nthese services. The Syracuse hospitals were able to phase out support for these\nprograms after they were operational in the nursing homes for an extended period of\ntime. The study data indicated that implementation of these programs limited the\nrate of increase of adult medicine stays and reduced adult surgery stays. The severity\nof illness for both major services increased in the Syracuse hospitals during this time.\nThis process required acute and long term care providers who were interested in\nmaking the process work for the benefit of the patient populations involved, as well\nas for the needs of their own organizations....
Background: Nutritional care is a basic human right for all people. Nevertheless, undernourishment is known to be\na frequent and serious health care problem among elderly hospitalized patients in Western Europe. Nutritional\ndocumentation contributes to ensuring proper nutritional treatment and care. Only a few studies have explored\nhow nurses document nutritional care in hospitals, and between hospitals and nursing homes. Available research\nsuggests that documentation practices are unsatisfactory. The aim of this study was to explore how nurses\ndocument nutritional treatment and care for elderly patients in hospitals and how nurses and undergraduate\nnurses communicate information about patients� nutritional status when elderly patients are transferred between\nhospital and nursing homes.\nMethods: A qualitative study was conducted using a phenomenological-hermeneutic approach. Data was collected\nin focus group interviews with 16 nurses in one large university hospital, and 11 nurses and 16 undergraduate\nnurses in five nursing homes associated with the university hospital. Participants from the university hospital\nrepresented a total of seven surgical and medical wards, all of which transferred patients to the associated nursing\nhomes. The catchment area of the hospital and the nursing homes represented approximately 10% of the Norwegian\npopulation in heterogenic urban and rural municipalities. Data were coded and analysed thematically within the three\ncontexts: self-understanding, critical common sense, and theoretical understanding.\nResults: The results were summarized under three main themes 1) inadequate documentation of nutritional status on\nhospital admission, 2) inadequate and unsystematic documentation of nutritional information during hospital stay,\n3) limited communication of nutritional information between hospital and nursing homes. The three main themes\nincluded seven sub-themes, which reflected the lack of nutritional screening and unsystematic documentation on\nadmission and during hospital stay. Further the sub-themes elucidated poor exchange of information between hospital\nand nursing homes regarding the nutritional status of patients.\nConclusion: Overall, the documentation of nutritional treatment and care for elderly patients was inadequate in the\nhospital and between health care settings. Inappropriate documentation can create a negative nutritional spiral that\nleads to increased risk of severe health related complications for elderly patients. Moreover, it hinders nutritional\nfollow-up across health care settings....
Rationale: Recent studies have reported the effectiveness of the early introduction of\nrehabilitation for preventing muscle weakness in patients in the intensive care unit\n(ICU). The early introduction of full-scale rehabilitation by a physical therapist is\ndifficult in some cases because of disease severity and/or patient conditions. However,\nmild mobilization by a nurse (MMN), as a part of standard care performed, may\nhave a positive effect on patient recovery. We examined the effect of the early introduction\nof MMN on the recovery of patients in the ICU. Methods: We retrospectively\nexamined patients admitted to Niigata University Hospital�s ICU during between\nApril 2014 and March 2015 who were receiving mechanical ventilation for 7\ndays or more. Patients were divided into two groups according to the date of initiation\nof MMN: group L comprised patients for whom MMN was started after 72\nhours and group E comprised patients for whom MMN was started within 72 hours\nafter ICU admission. The data were analyzed using the Fisher test, Mann-Whitney U\ntest, and Wilcoxon test. Statistical significance was defined as P < 0.05. Results: Sixty-\nthree patients were included: 42 patients in group L and 21 in group E. There was\nno significant difference between the two groups in patients� background, including\nthe type of illness, steroid use, presence of sepsis or diabetes, and sequential organ\nfailure assessment (SOFA) score on ICU admission; however, the SOFA score at ICU\ndischarge was significantly decreased in group E compared to that in group L (6.21\nversus 4.30; P = 0.034). Conclusion: Our results indicate that MMN may reduce\ndisease severity if started within 72 hours after ICU admission....
Background: Intravitreal injections (IVI) of anti-vascular endothelial growth factor (anti-VEGF) now improve or\nstabilize visual acuity in a number of previously untreatable eye diseases, of which the main are age-related macular\ndegeneration, retinal vein occlusion and diabetic macular edema. Most patients require multiple injections over\nlengthy periods of time and the prevalence of treatable conditions is increasing. Anti-VEGF IVI normally\nadministered by physicians, therefore represent a considerable workload on ophthalmologic clinics and will\ncontinue to do so in the near future. Nurse-administered IVI may relieve this workload, but the safety, cost and\npatient satisfaction of such an extended role for nurses in ophthalmologic clinics has not earlier been investigated.\nTo investigate these outcomes following independent anti-VEGF IVI by trained nurses, a noninferiority randomized\ncontrolled trial is being conducted.\nMethods/Design: Patients eligible for anti-VEGF treatment, minimum 304, are recruited and randomized to IVI\nadministration by either trained nurses or physicians. The primary outcome is safety, measured by difference in\nmean change in visual acuity between the two groups during an observation period of 12 months. Secondary\noutcomes are incidence of ocular adverse events, cost per patient and patient satisfaction.\nDiscussion: This study protocol describes the design of the first randomized controlled trial of nurse-administered\nIVI of anti-VEGF. The study is designed to examine safety, cost and patient satisfaction during 12 months follow-up....
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