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1.
Mymensingh Med J ; 29(1): 86-91, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915341

RESUMO

Among nurses due to inadequate pain management knowledge and practice skills, children's pain is often under treated. This study aimed to examine the level of knowledge and practice on pediatric pain management among nurses in Bangladesh. This was a descriptive survey study involving total 150 clinical pediatric nurses from two Medical College Hospital and a University hospital in Bangladesh. The data collection tool consisted of demographic data form, 32-items nurses' knowledge. There were 32 true and false questions related to nurses' knowledge on pediatric pain management in Bangladesh. The response formats to each item for correct answer was 1 and incorrect answer 0. The total scores were categorized into three levels including low (0-20), moderate (21-23) and high (24 and above). The data collection tool consisted of demographic data form, 19-item practice related questionnaire on pediatric pain management. Nurses' practice on pediatric pain management contained 19 items with 5-points Likert's scale ranging from 1=Never practice to 5=constantly practice. For each item, a score of 5 was accorded for constantly and 1 for never. The score ranged from 19-95. The total scores were categorized into three levels including low (19-38), moderate (39-76) and high (77-95). The results demonstrated that most of the nurses' knowledge score on pediatric pain management was at moderate level (mean=21.50, SD=2.35). Nurses' practice on pediatric pain management was also at moderate level (mean=75.45, SD=8.24). The relationship between nurses' knowledge and practice was not significant. In addition, nurses' knowledge and practice with demographic variables; there was significant relationship between nurse's knowledge and existence of pain management protocol, nurses' practice and their current position in unit and with reading nursing journal. This study showed moderate level of knowledge and practice indicating that they need to be enhanced the knowledge and practice skills in pediatric pain management.


Assuntos
Competência Clínica , Conhecimentos, Atitudes e Prática em Saúde , Manejo da Dor/enfermagem , Enfermagem Pediátrica , Adulto , Bangladesh , Criança , Feminino , Humanos , Masculino , Papel do Profissional de Enfermagem , Recursos Humanos de Enfermagem no Hospital , Dor , Inquéritos e Questionários
4.
Nurs Older People ; 32(1): 21-25, 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31990162

RESUMO

With an increasingly ageing population comes a greater risk of frailty, a distinct health state in which multiple body systems gradually lose their inbuilt reserves. The ability to recognise important frailty markers and conduct specialist comprehensive assessments of potentially frail older people admitted to acute hospitals is important to improve their health and well-being. This article explores the role of the advanced nurse practitioner (ANP) in identifying frailty and leading comprehensive geriatric assessment (CGA) for older people admitted to acute hospital settings. A small evaluation of CGA led by an ANP in a district general hospital found that a well-rounded assessment of patients living with frailty could be carried out, and that such assessments reduced unscheduled readmission within 28 days of discharge and overall length of hospital stay by six days. In a challenging climate, in which healthcare services seek to deliver effective and efficient care to the frail older population, ANPs can ensure a timely and specialist approach to CGA.


Assuntos
Prática Avançada de Enfermagem , Fragilidade/enfermagem , Avaliação Geriátrica , Idoso , Idoso de 80 Anos ou mais , Feminino , Idoso Fragilizado , Hospitalização , Humanos , Masculino
5.
Medicine (Baltimore) ; 99(2): e18741, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914092

RESUMO

Inappropriate care for patients with cognitive dysfunction in the hospital could worsen quality of care and medical service satisfaction.All elderly participants were recruited from acute wards of 5 departments in an university hospital. They were administered the Chinese version of Ascertain Dementia 8 (AD8) at admission and the Nursing Service Satisfaction Questionnaire before discharge.A total of 345 participants completed the study. There were 91 (26.4%) participants with AD8 ≥ 2, the cut-off value of high risk of dementia. The prevalence was much higher than prior community-based reports. The Nursing Service Satisfaction Score was significantly lower in AD8 ≥ 2 than in AD8 < 2 (56.99 ±â€Š0.94 vs 60.55 ±â€Š0.48, P < .01).Using AD8 in hospital-based screening might be more efficient than in the community in terms of cost-effectiveness due to higher positive rate and easier approach to diagnostic facilities. AD8 ≥ 2 is also an indicator to identify care dissatisfaction among inpatients. By identifying patients with cognitive dysfunction, such as its related communication barriers, care systems could be tailored for more friendly services.


Assuntos
Demência/diagnóstico , Demência/enfermagem , Programas de Rastreamento/métodos , Satisfação do Paciente , Inquéritos e Questionários/normas , Idoso , Idoso de 80 Anos ou mais , Análise Custo-Benefício , Demência/epidemiologia , Feminino , Humanos , Masculino , Programas de Rastreamento/economia , Programas de Rastreamento/normas , Pessoa de Meia-Idade , Qualidade da Assistência à Saúde/normas , Reprodutibilidade dos Testes
6.
Nursing ; 50(2): 24-29, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31904617

RESUMO

Historically, MRI was contraindicated in patients with cardiovascular implantable electronic devices because the devices' metallic components made this imaging study unsafe. Advances over the last decade have now made MRI safe for many of these patients. This article examines the risks of MRI technology for this patient population and reviews recent guidelines from the Heart Rhythm Society.


Assuntos
Desfibriladores Implantáveis , Imagem por Ressonância Magnética/normas , Marca-Passo Artificial , Segurança do Paciente/normas , Desfibriladores Implantáveis/efeitos adversos , Humanos , Imagem por Ressonância Magnética/efeitos adversos , Imagem por Ressonância Magnética/enfermagem , Marca-Passo Artificial/efeitos adversos
7.
Nursing ; 50(2): 41-44, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31904618

RESUMO

This article discusses an evidence- and consensus-based support-surface algorithm designed to help clinicians choose the most appropriate support surface for preventing or treating pressure injuries based on patient, nurse, and institutional considerations.


Assuntos
Algoritmos , Leitos , Tomada de Decisão Clínica/métodos , Enfermeiras Clínicas/psicologia , Lesão por Pressão/enfermagem , Consenso , Prática Clínica Baseada em Evidências , Humanos , Fatores de Risco
8.
Nursing ; 50(2): 48-55, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31977806

RESUMO

Low back pain (LBP) is one of the most frequent patient complaints in primary care. This article discusses the assessment and treatment of patients with LBP, including nonpharmacologic and pharmacologic approaches.


Assuntos
Dor Lombar/enfermagem , Atenção Primária à Saúde , Adulto , Humanos , Anamnese , Avaliação em Enfermagem , Exame Físico/enfermagem , Fatores de Risco
9.
Nursing ; 50(2): 56-60, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31977807

RESUMO

Venomous snakebites are surprisingly common in the US. This article provides an overview of what to do when a patient has been bitten by a North American pit viper, a venomous subset of indigenous snakes.


Assuntos
Crotalinae , Mordeduras de Serpentes/enfermagem , Animais , Antivenenos/administração & dosagem , Humanos , Diagnóstico de Enfermagem , Estados Unidos
12.
Br J Nurs ; 29(1): 62-63, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31917944

RESUMO

Emeritus Professor Alan Glasper, from the University of Southampton, discusses processes for ensuring that all patients have an up-to-date personalised care plan that details all their care needs during admission to hospital.


Assuntos
Planejamento de Assistência ao Paciente/organização & administração , Medicina de Precisão/métodos , Medicina de Precisão/enfermagem , Humanos , Medicina Estatal , Reino Unido
13.
Hu Li Za Zhi ; 67(1): 81-88, 2020 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-31960399

RESUMO

BACKGROUND & PROBLEMS: Early rehabilitation after stroke is important for the recovery of bodily functions in stroke patients. However, the percentage of completion of early limb rehabilitation among stroke patients is only 16%. PURPOSE: Raise the early rehabilitation intervention rate to 88% for patients with stroke within 24 hours of hospitalization. RESOLUTION: We developed an education course on post-stroke rehabilitation and a related e-Learning course as well as organized an 'alliance for recovery' team. In addition, we established a standard for post-stroke relay rehabilitation and designed rehabilitation relay cards, Xbox rehabilitation games, and nine squares challenge for brain stroke care. RESULTS: The accuracy of the knowledge of nursing staff related to physical rehabilitation improved from 72.4% to 100%; the accuracy of their perceptions regarding early limb rehabilitation increased from 16% to 100%; and patient satisfaction increased from 68% to 98%. CONCLUSIONS: We deployed diverse and innovative strategies to assist limb rehabilitation in patients with stroke. Patients and caregivers should be encouraged to participate in early rehabilitation and related programs and should apply the skills and rehabilitation activities learned to daily life.


Assuntos
Extremidades/fisiopatologia , Reabilitação do Acidente Vascular Cerebral/métodos , Reabilitação do Acidente Vascular Cerebral/enfermagem , Acidente Vascular Cerebral/fisiopatologia , Difusão de Inovações , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pesquisa em Avaliação de Enfermagem , Recursos Humanos de Enfermagem no Hospital/educação , Recursos Humanos de Enfermagem no Hospital/psicologia , Satisfação do Paciente/estatística & dados numéricos , Desenvolvimento de Programas
14.
Hu Li Za Zhi ; 67(1): 89-97, 2020 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-31960400

RESUMO

BACKGROUND & PROBLEMS: Dermatitis associated with incontinence was the cause of 55% of the total of 386 skin lesion cases in our unit between July and December 2016 and 40.3% of the skin lesion cases in our unit during March and April 2017, indicating the importance of this issue. Our survey showed that the nurses in our unit scored an average of 78.9% on knowledge related to the prevention of incontinence-associated dermatitis and only 58.2% on knowledge related to incontinence-associated dermatitis care. The main reasons for the high incidence of incontinence-associated dermatitis included: incorrect implementation of care, no discussion with the medical team, no incontinence care standards, no continue education, lack of related equipment for preventing incontinence-associated dermatitis, unit patient characteristics, and drugs used. PURPOSE: To reduce the incidence of incontinence-associated dermatitis from 40.3% to 32.0%. RESOLUTION: A care-bundle in treating incontinence-associated dermatitis was implemented by designing an assessment flow chart for evaluating incontinence-associated dermatitis, by setting standard guidelines for incontinence-associated dermatitis care, by distributing reminder cards, special toolboxes, and by changing how the little diapers were wrapped. In-service education lessons, inter-professional collaborative practice, and regular internal audit were also executed. RESULTS: After project implementation, the knowledge score of nurses increased from 78.9% to 95.7%; the correctness of care score, as retested in November 2017, increased from 58.2% to 91.5%; and the incidence of incontinence-associated dermatitis dropped to 18.5%. These improvements achieved the goals of this project. Furthermore, the sustained effect of the project measures was confirmed, with the incidence of incontinence-associated dermatitis determined as 17.9% at three months after completion of the project. CONCLUSIONS: Formulating care procedures and cooperating with medical team personnel to provide creative care measures were shown to effectively decrease the incidence of incontinence-associated dermatitis and improve overall quality of care. The findings of this project support the revision by hospitals of regulations and procedures related to adult incontinence-associated dermatitis to provide caregivers with basis-of-care standards and uniform care procedures and standards in support of effective patient skin care regimens.


Assuntos
Dermatite/prevenção & controle , Incontinência Fecal/complicações , Relações Interprofissionais , Recursos Humanos de Enfermagem no Hospital/psicologia , Higiene da Pele/enfermagem , Incontinência Urinária/complicações , Adulto , Dermatite/epidemiologia , Incontinência Fecal/enfermagem , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Incidência , Pesquisa em Avaliação de Enfermagem , Incontinência Urinária/enfermagem
15.
Hu Li Za Zhi ; 67(1): 98-105, 2020 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-31960401

RESUMO

Alzheimer's disease (AD) is one of the most common diseases in older populations. Its main clinical features include cognitive dysfunction, affective disorder, and abnormal mental behavior. Due to the lack of therapeutic drugs, professional care has become an important diagnostic and therapeutic strategy for Alzheimer's disease patients. At present, most Alzheimer's disease patients are cared for at home by relatives or caregivers, and less than l0% of city-based patients receive care in old-age institutions. Due to mixed treatment regimens in the hospital, care services do not necessarily match patient care needs and thus Alzheimer's disease patients do not receive adequate treatment. Developed countries have a mature care system for the elderly, but no graded care model for the elderly with Alzheimer's disease currently exists in China. In this paper, the author draws on the experience of developed countries to construct an index system for the graded care of Alzheimer's disease patients that is suited to conditions in China. This article addresses the burden faced by the elderly with Alzheimer's disease and the current standard of care for the elderly at home and abroad. After explaining the necessity of constructing a care model for the elderly with Alzheimer's disease, the author then explains the practicability of the care system proposed in this study in order to provide a whole-course care model for the mentally impaired elderly in China.


Assuntos
Doença de Alzheimer/enfermagem , Modelos de Enfermagem , Garantia da Qualidade dos Cuidados de Saúde/métodos , Idoso , China , Humanos , Pesquisa em Avaliação de Enfermagem
16.
Hu Li Za Zhi ; 67(1): 113-119, 2020 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-31960403

RESUMO

The article describes the author's nursing experience providing psychiatric homecare to a patient with chronic schizophrenia using the concept of resilience. Holistic nursing assessments were conducted via clinical observations during home visits every two weeks from May 24th to September 20th, 2018. Through these assessments, the main health problems of the patient were defined as ineffective self-health management, ineffective coping skills, and insufficient resilience. The nursing interventions implemented were designed to establish the patient's capacity to effectively and correctly self-manage health status, achieve emotional accommodation, and reduce parent-child conflicts. In order to enhance the resilience of the patient, the patient was guided to review important support resources over the course of illness, to detect the barriers of returning society, to apply the beneficial skills of health management, and then extend the status of employment and to enhance self-fulfillment.


Assuntos
Resiliência Psicológica , Esquizofrenia/enfermagem , Psicologia do Esquizofrênico , Adaptação Psicológica , Serviços de Assistência Domiciliar , Humanos , Autogestão/psicologia
17.
Br J Nurs ; 29(2): S18-S23, 2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31972104

RESUMO

BACKGROUND: Intravenous therapy is an integral part of professional nursing practice. Nurses have a responsibility to recognise risk factors for phlebitis. AIMS: To investigate nurses' perceptions of risk factors for phlebitis in a tertiary teaching hospital in north-east Peninsular Malaysia. METHODS: A cross-sectional study of 199 randomly selected nurses were surveyed for their perceptions of risk factors for phlebitis using a self-administered questionnaire. FINDINGS: More than half of the nurses (56.8%) had a good perception levels of risk factors for phlebitis. There was a significant association between the clinical area and nurses' perceptions of risk factors for phlebitis (p=0.04). Nurses working in medical, orthopaedic, and surgical areas had slightly better perceptions than nurses working in multidisciplinary and oncology areas. CONCLUSION: These findings suggest that nurses need to continually improve their knowledge about risk factors for phlebitis to ensure safer nursing practice.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Recursos Humanos de Enfermagem no Hospital/psicologia , Flebite/enfermagem , Adulto , Estudos Transversais , Feminino , Hospitais de Ensino , Humanos , Malásia , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Fatores de Risco , Inquéritos e Questionários , Centros de Atenção Terciária , Adulto Jovem
18.
Br J Nurs ; 29(2): S24-S26, 2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31972108

RESUMO

PURPOSE: Preventing CLABSI events in the dialysis inpatient population represents significant challenges. Bacteremia associated with lines or grafts are common health-associated infections that lead to adverse patient outcomes. Dialysis patients represent a much higher infection risk due to health frequency needs, more frequent hospitalizations, multiple comorbidity issues, fistula functionality, and multiple attempts for line access leading to additional complications, costs, morbidity, and mortality. METHODS: An observational study was conducted including central line device days, CLABSI events, and possible confounding variables in admitted dialysis patients. All CLABSI data were identified according to the Centers for Disease Control and Prevention's National Healthcare Safety Network's definitions for CLABSIs. The intervention involved the removal of 70% alcohol swabs and alcohol hub disinfecting caps, then replacing with swabs containing 3.15% chlorhexidine gluconate/70% alcohol for central line hub disinfection and vascular graft access skin disinfection. RESULTS: The 5-year preintervention period (2008-2012) involved 7568 central line days, 11 CLABSI events, and a 1.45 per 1000 device day rate. The 6-month trial period involved 1559 central line days and no CLABSI events. The 5-year postimplementation period (2013-2017) involved 9787 central line days, 5 CLABSI events, and a 0.51 per 1000 device day rate. The postimplementation period represented a statistically significant (P value=0.0493) reduction with 65% fewer CLABSI events compared with the preimplementation period. LIMITATIONS: A limitation was variations in scrub time and dry time during central venous catheter hub access. While we were comparing 2 products, behavioral practices using these 2 products were possible influencers and represent a possible confounding variable. CONCLUSIONS: This study found that using alcohol with chlorhexidine gluconate prior to accessing central line hubs and vascular grafts allows for reduction in CLABSI events and sustains statistically significant lower CLABSI rates in the inpatient dialysis population. HIGHLIGHTS Using alcohol with chlorhexidine gluconate (CHG) before accessing central line hubs helps reduce central line-associated bloodstream infection (CLABSI) events Using alcohol with CHG before accessing vascular grafts helps reduce CLABSI events A statistically significant reduction (65%) in CLABSI events occurred after use. Statistically significant lower CLABSI rates are sustainable with use of alcohol with CHG.


Assuntos
Bacteriemia/prevenção & controle , Infecções Relacionadas a Cateter/prevenção & controle , Infecção Hospitalar/prevenção & controle , Desinfecção/métodos , Diálise Renal/enfermagem , Álcoois/administração & dosagem , Cateterismo Venoso Central/efeitos adversos , Clorexidina/administração & dosagem , Clorexidina/análogos & derivados , Humanos , Pesquisa em Avaliação de Enfermagem
19.
Br J Nurs ; 29(2): 111-117, 2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31972112

RESUMO

BACKGROUND: Cancer-related fatigue (CRF) is considered to be one of the most common symptoms reported by cancer patients. However, little information is available regarding the variables associated with CRF among Jordanian patients. AIMS: To assess the prevalence of CRF and explore its predictors among Jordanian patients. METHODS: A cross-sectional survey design was used. FINDINGS: Of the 240 patients surveyed, 210 (87.5%) had fatigue at the time of the survey. The total mean fatigue score was 6.2 (SD=1.7) out of a maximum possible score of 10. The results also showed that being unemployed, with longer hospitalisation, low haemoglobin, and having lung cancer seem to predict higher levels of CRF. CONCLUSION: Several variables and factors associated with CRF were identified. In response to these results, healthcare providers should pay more attention to CRF, which needs to be assessed on a regular basis and to be managed with the available pharmacological and non-pharmacological interventions.


Assuntos
Fadiga/enfermagem , Neoplasias/complicações , Adulto , Estudos Transversais , Fadiga/epidemiologia , Feminino , Humanos , Jordânia/epidemiologia , Masculino , Pessoa de Meia-Idade , Avaliação em Enfermagem
20.
Gesundheitswesen ; 82(1): 75-81, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-30321878

RESUMO

INTRODUCTION: There is an increasing number of ventilated and other technology-dependent patients, cared for in their own homes or in shared apartments in Germany. Issues of patient safety have hardly been examined in this context. In this follow-up of a survey of patients and their relatives, the perspective of professional players on the subject of safety in intensive home care is explored. METHODS: Professional players in 6 heterogeneous, non-natural focus groups were faced with experiences and perspectives of ventilated patients and their relatives in a qualitative health care services research. These players were asked for their perspectives on the issue of patient safety in intensive home care. The collected data were analyzed in terms of discourse as well as content. RESULTS: The subjective safety dimensions addressed by the ventilated patients and their relatives was considered as important by the professional players in many respects. However, demands from relatives for more participation were considered with skepticism. Safety in intensive home care was perceived as under threat by a lack of cooperation and coordination, skills shortage and skills gaps. In particular, caregivers with key tasks of care provision and thus with special responsibility for patient safety see these corresponding challenges. CONCLUSION: The results provide a basis for safety work in intensive home care. Among other things they point out the need to develop user-centered safety concepts, a safety culture at the organizational level as well as accompanying legal regulation.


Assuntos
Cuidadores , Cuidados Críticos , Serviços de Assistência Domiciliar , Respiração Artificial , Alemanha , Humanos , Segurança do Paciente , Respiração Artificial/enfermagem
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