Current Issue : April - June Volume : 2018 Issue Number : 2 Articles : 6 Articles
Introduction. The prevalence of diabetes mellitus is rapidly rising in SSA. Interventions are needed to support the decentralization\nof services to improve and expand access to care. We describe a clinical mentorship and quality improvement program that\nconnected nurse mentors with nurse mentees to support the decentralization of type 2 diabetes care in rural Rwanda. Methods.\nThis is a descriptive study. Routinely collected data from patients with type 2 diabetes cared for at rural health center NCD\nclinics between January 1, 2013 and December 31, 2015, were extracted from EMR system. Data collected as part of the clinical\nmentorship program were extracted from an electronic database. Summary statistics are reported. Results. The patient\npopulation reflects the rural settings, with low rates of traditional NCD risk factors: 5.6% of patients were current smokers,\n11.0% were current consumers of alcohol, and 11.9% were obese. Of 263 observed nurse mentee-patient encounters, mentor and\nmentee agreed on diagnosis 94.4% of the time. Similarly, agreement levels were high for medication, laboratory exam, and\nfollow-up plans, at 86.3%, 87.1%, and 92.4%, respectively. Conclusion. Nurses that receive mentorship can adhere to a type 2\ndiabetes treatment protocol in rural Rwanda primary health care settings....
Background.The incidence of healthcare-associated infections (HAIs) in the public health sector in South Africa is not known due\nto the lack of a surveillance system. We report on the challenges experienced in the implementation of a surveillance system for\nHAIs in intensive care units (ICUs). Methods. A passive, paper-based surveillance system was piloted in eight ICUs to measure the\nincidence of ventilator-associated pneumonia, catheter-associated urinary tract infection, and central line-associated bloodstream\ninfection. Extensive consultation with the ICU clinical and nursing managers informed the development of the surveillance system.\nThe Plan-Do-Study-Act method was utilized to guide the implementation of the surveillance. Results.The intended outputs of the\nsurveillance system were not fully realized due to incomplete data. The organizational culture did not promote the collection of\nsurveillance data.Nurses felt that the surveillance formadded to their workload, and the infection control practitioners were unable\nto adequately supervise the process due to competing work demands. Conclusions. A manual system that adds to the administrative\nworkload of nurses is not an effective method of measuring the burden of HAIs. Change management is required to promote an\norganizational culture that supports accurate data collection for HAIs....
patients and is more affordable. We compared nutritional care practice in our ICU\nbefore and after modification of our nutrition support protocol: Several comprehensive\ndocuments were substituted with one flow chart and early EN was encouraged.\nDesign: Retrospective observational study.\nMethods: Nutritional data were collected from admission up to 7 days in 25 patients\nbefore and 25 patients after protocol modification.\nResults: The percentage of patients receiving EN within 72 hr of admission increased\nfrom 64% before to 88% after protocol modification. Cumulative percentage energy\nfrom EN during ICU days 1ââ?¬â??4 increased from 26ââ?¬â??89% of total kcal. Overall amount of\nnutrition administered enterally increased, with a corresponding marked decline in use\nof parenteral nutrition. Pre-modification,\n>80% of patients received >65% of their calculated\nnutrition requirements by ICU Day 4; post-modification this goal was achieved\nby Day 7....
Aim: To identify and describe the role of non-prescribing nurses in medical prescription, through a critical\nsynthesis of all the studies published worldwide answering this question.\nBackground: Medical prescription is a prerogative of the physician. Yet, the final decision for prescribing is\nmost often the conjunction of different factors and actors. What could be the role of non-prescribing nurses\nin medical prescription?\nDesign: A systematic literature review.\nMethods: A literature search of the databases, the Ovid MEDLINE database, PubMed, Web of Science,\nCochrane, and Cumulative Index to Nursing and Allied Health Literature (CINAHL), was done to identify\nstudies that describe the nurse�s role in medical prescription up to May 2017. A quality assessment of relevant\nstudies was performed.\nResults: Four studies were included in this review. The overall methodological quality of the studies was\nintermediate (score: 8.5 of 12). Analyses of the included articles show the nurses have an essential role in the\nadministration of medications and in the follow-up of the drug consequences. In addition, nurses tend to share\nthe decision regarding prescribing with the doctors through an inter-professional collaborative approach.\nNurses do not have sufficient knowledge about pharmacology and drug management.\nConclusions: Our systematic review emphasizes the importance of multidisciplinary collaboration between\nnurses and other health professionals in acute care settings. The strong involvement of nurses could provide\na dialogue to strengthen best practice. Improving the nurses� knowledge and their skills are likely to enhance\nthe optimization of treatment.\nRelevance to Clinical Practice: The current literature suggests a refinement of pharmacological knowledge\namong nurses and effective nurse-doctor interactions to guide the best medical prescribing....
Using an oral history approach, this study analyzed the narratives obtained\nfrom semi-structured interviews administered to three Japanese women who\nworked as nurses for the Hiroshima Atomic Bomb Casualty Commission\n(ABCC). The analysis of the data in the narratives showed details of the health\nsurveys and health checkups conducted during the early period of operation\nof ABCC. During the early period of operation of ABCC some survivors\nshowed negative behaviors toward the health surveys and health checkups at\nthe ABCC. However, it can be inferred that dedicated nursing played an important\nrole in alleviating the stress and emotional issues of survivors at the\nhealth surveys and health checkups. The findings of the study could be beneficial\nto research into nursing activities for patients exposed to radiation at the\npresent day....
Background. Stress has both physiological and psychological effects and can negatively impact patients� treatment and recovery.\nWe examined whether the aromatherapy alleviated patients� stress and improved their sleep quality and provided data that can be\nutilized in clinical settings. Methods. This was a nonrandomised controlled experimental study. Participants included lucid adult\npatients who were admitted to the intensive care unit and had spent more than two nights there. The experimental treatment\nrequired participants to engage in deep breathing with essential oils as part of the aromatherapy. The control group was instructed\nto go to sleep without receiving the lavender aroma oil. Results. The experimental group and control group showed a significant\ndifference in perceived stress (...
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