RESUMO
In rehabilitation nursing, the patient classification systems or acuity models and nurse-staffing ratios are not supported by empirical evidence. Moreover there are no studies published characterizing nursing hours per patient day, proportion of RN staff and impact of agency nurses in inpatient rehabilitation settings. The purpose of this prospective observational study was to describe rehabilitation nurse staffing patterns, to validate the impact of rehabilitation nursing on patient outcomes, and to test whether existing patient measures on severity and outcomes in rehabilitation could be used as a proxy for burden of care to predict rehabilitation nurse staffing ceilings and daily nurse staffing requirements. A total of 54 rehabilitation facilities in the United States, stratified by geography, were randomly selected to participate in the study.
Assuntos
Recursos Humanos de Enfermagem Hospitalar/organização & administração , Admissão e Escalonamento de Pessoal/organização & administração , Enfermagem em Reabilitação/organização & administração , Índice de Gravidade de Doença , Carga de Trabalho/estatística & dados numéricos , Atividades Cotidianas , Competência Clínica , Grupos Diagnósticos Relacionados/estatística & dados numéricos , Medicina Baseada em Evidências , Humanos , Tempo de Internação/estatística & dados numéricos , Modelos de Enfermagem , Avaliação das Necessidades/organização & administração , Pesquisa em Administração de Enfermagem , Pesquisa em Avaliação de Enfermagem , Recursos Humanos de Enfermagem Hospitalar/educação , Avaliação de Resultados em Cuidados de Saúde , Admissão do Paciente , Valor Preditivo dos Testes , Estudos Prospectivos , Indicadores de Qualidade em Assistência à Saúde , Enfermagem em Reabilitação/educação , Estados UnidosRESUMO
PURPOSE: The purpose of this study was to compare voiding patterns after catheter removal between post-stroke individuals with symptoms of sleep-disordered breathing (SDB) and those without symptoms of SDB. METHOD: Medical records were reviewed for documentation of SDB symptoms of obstructive sleep apnea (OSA) and voiding patterns before and after catheter removal. SDB was based on established criteria for excessive sleepiness used in the Epworth Sleepiness Scale (Chervin, Aldrich, Pickett, & Guilleminault, 1997). Data on voiding patterns and nocturia were collected for 4 nights after catheter removal. Demographic data, co-morbid conditions, usual hours of sleep, and use of a benzodiazepine medication as a nightly sleep aid were also reviewed. Descriptive statistics and Chi-square analysis were performed to describe the sample, use of nightly sedation, and to compare the incidence of nocturia for 4 consecutive nights after catheter removal in subjects who had SDB symptoms of OSA with those who did not have SDB symptoms of OSA. FINDINGS: Study findings suggest that in post-stroke subjects (a) SDB symptoms of OSA are associated with more episodes of nocturia after evening catheter removal, and (b) use of sedatives for sleep is associated with an increased incidence of nocturia.
Assuntos
Noctúria/etiologia , Síndromes da Apneia do Sono/complicações , Apneia Obstrutiva do Sono/complicações , Acidente Vascular Cerebral/complicações , Idoso , Benzodiazepinas/efeitos adversos , Distribuição de Qui-Quadrado , Ritmo Circadiano , Comorbidade , Complicações do Diabetes/complicações , Insuficiência Cardíaca/complicações , Humanos , Hipertensão/complicações , Hipnóticos e Sedativos/efeitos adversos , Incidência , Noctúria/epidemiologia , Sistema Renina-Angiotensina , Estudos Retrospectivos , Fatores de Risco , Reabilitação do Acidente Vascular Cerebral , Fatores de Tempo , Cateterismo UrinárioRESUMO
PURPOSE: The purpose of this study was to compare the effect of urinary catheter removal at 7:00 a.m. with removal at 10:00 p.m. on (a) the length of time to first void after catheter removal, (b) the amount of the first void, (c) post-void-residual urine, and (d) the number of subjects requiring re-catheterization. METHODS: A randomized, comparative design was used. Stroke patients, over the age of 18 years, admitted to a stroke unit, were approached about study participation. Forty-five subjects were enrolled: 26 in Group A (10:00 p.m. removal) and 19 in Group B (7:00 a.m. removal). Groups were compared using t-tests and Chi-square. FINDINGS: No significant differences were identified between the two groups with regard to time to void, volume of first void, post-void residual urine, or the number of subjects requiring recatheterization.