scholarly journals The nursing management of diarrhoea and constipation before and after the implementation of a bowel management protocol

2001 ◽  
Vol 14 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Sinead McKenna ◽  
Marianne Wallis ◽  
Alison Brannelly ◽  
Jillian Cawood
Keyword(s):  
Nursing Management ◽  
Bowel Management ◽  
Management Protocol ◽  
Before And After

The Effect of Alarm Fatigue Nursing Management Protocol on Critical Care Nurses' Experience

2020 ◽  
Vol 11 (4) ◽  
pp. 224-241
Author(s):  
Amina Mohamed Abdel Fatah Sliman ◽  
Wafaa Wahdan Abd El-Aziz ◽  
Hend Elsayed Mansour
Keyword(s):  
Critical Care ◽  
Critical Care Nurses ◽  
Nursing Management ◽  
Alarm Fatigue ◽  
Management Protocol

Implementation of a Standardized Perioperative Pain Management Protocol to Reduce Opioid Prescriptions in Otolaryngologic Surgery

2022 ◽  
pp. 019459982110711
Author(s):  
Michael T. Chang ◽  
M. Lauren Lalakea ◽  
Kimberly Shepard ◽  
Micah Saste ◽  
Amanda Munoz ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Lower Amount ◽  
Opioid Use ◽  
Protocol Implementation ◽  
Perioperative Pain ◽  
Management Protocol ◽  
Before And After ◽  
Perioperative Pain Management ◽  
Low Levels

Objective To evaluate the efficacy of implementing a standardized multimodal perioperative pain management protocol in reducing opioid prescriptions following otolaryngologic surgery. Study Design Retrospective cohort study. Setting County hospital otolaryngology practice. Methods A perioperative pain management protocol was implemented in adults undergoing otolaryngologic surgery. This protocol included preoperative patient education and a postoperative multimodal pain regimen stratified by pain level: mild, intermediate, and high. Opioid prescriptions were compared between patient cohorts before and after protocol implementation. Patients in the pain protocol were surveyed regarding pain levels and opioid use. Results We analyzed 210 patients (105 preprotocol and 105 postprotocol). Mean ± SD morphine milligram equivalents (MMEs) prescribed decreased from 132.5 ± 117.8 to 53.6 ± 63.9 ( P < .05) following protocol implementation. Mean MMEs prescribed significantly decreased ( P < .05) for each procedure pain tier: mild (107.4 to 40.5), intermediate (112.8 to 48.1), and high (240.4 to 105.0). Mean MMEs prescribed significantly decreased ( P < .05) for each procedure type: endocrine (105.6 to 44.4), facial plastics (225.0 to 50.0), general (160.9 to 105.7), head and neck oncology (138.6 to 77.1), laryngology (53.8 to 12.5), otology (77.5 to 42.9), rhinology (142.2 to 44.4), and trauma (288.0 to 24.5). Protocol patients reported a mean 1-week postoperative pain score of 3.4, used opioids for a mean 3.1 days, and used only 39% of their prescribed opioids. Conclusion Preoperative counseling and standardization of a multimodal perioperative pain regimen for otolaryngology procedures can effectively lower amount of opioid prescriptions while maintaining low levels of postoperative pain.

scholarly journals Creating and Implementing a Protocol for the Management of Patients in Skeletal Traction: A Quality Improvement Project

2021 ◽  
Vol 14 ◽  
pp. 240-242
Author(s):  
Justin Cline ◽  
Jack Nolte ◽  
Gregory Mendez ◽  
Jordan Willis ◽  
Andrew Bachinskas ◽  
...  
Keyword(s):  
Nursing Management ◽  
Hospital Policy ◽  
Skeletal Traction ◽  
Improvement Project ◽  
Fracture Stabilization ◽  
Management Protocol ◽  
Key Points ◽  
Post Test ◽  
Manual Traction ◽  
Hospital Protocol

Introduction.Skeletal traction use generally has decreased over generations and is used most often for temporary fracture stabilization. Proper nursing management of patients in skeletal traction is crucial. A hospital protocol was created and implemented to educate and direct registered nurses (RNs) in the care of patients requiring skeletal traction. Method.A skeletal traction management protocol was drafted and implemented as hospital policy. Twenty-nine RNs from an orthopaedic unit at a level 1 trauma center attended a financially compensated, 45-minute, in-person, off-shift educational session. An anonymous pre-test utilizing a 5-point Likert scale was completed to assess RN knowledge and comfort regarding the following topics of traction care: pin care, manual traction, frame assembly, weight application and removal, skin evaluation, neurovascular checks, and reporting issues. The RNs were provided with a copy of the new hospital policy and key points were highlighted and demonstrated. After the demonstration, the RNs were given a post-test to assess their perceived knowledge and comfort with traction care. Results.Statistically significant improvements in RN knowledge and comfort were seen in six of the seven evaluated topics. The greatest increase was seen in the manual traction topic. No significant change regarding neurovascular checks was observed with this topic having the highest pre-test scores. Conclusion. A hospital protocol was created successfully and implemented that significantly improved the level of RN knowledge and comfort with the management of patients requiring skeletal traction. Future studies should assess the effectiveness of annual education regarding the traction policy.

Abstract WP356: Impact of a Designed Acute Stroke Nursing Management Protocol on Nurse’s Knowledge and Practices

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Samah Zidan ◽  
Hanaa Elfeky ◽  
Warda Yossif ◽  
Foad Abd Allah
Keyword(s):  
Acute Stroke ◽  
Nursing Management ◽  
Management Protocol

Establishment of a multidisciplinary concussion program: impact of standardization on patient care and resource utilization

2014 ◽  
Vol 13 (1) ◽  
pp. 82-89 ◽  
Author(s):  
Sara Anne Wilkins ◽  
Chevis N. Shannon ◽  
Steven T. Brown ◽  
E. Haley Vance ◽  
Drew Ferguson ◽  
...  
Keyword(s):  
Emergency Department ◽  
Retrospective Study ◽  
Resource Utilization ◽  
Media Coverage ◽  
Public Awareness ◽  
Return To Play ◽  
Management Protocol ◽  
Before And After ◽  
Multiple Variables ◽  
The Impact

Object Recent legislation and media coverage have heightened awareness of concussion in youth sports. Previous work by the authors' group defined significant variation of care in management of children with concussion. To address this variation, a multidisciplinary concussion program was established based on a uniform management protocol, with emphasis on community outreach via traditional media sources and the Internet. This retrospective study evaluates the impact of standardization of concussion care and resource utilization before and after standardization in a large regional pediatric hospital center. Methods This retrospective study included all patients younger than 18 years of age evaluated for sports-related concussion between January 1, 2007, and December 31, 2011. Emergency department, sports medicine, and neurosurgery records were reviewed. Data collected included demographics, injury details, clinical course, Sports Concussion Assessment Tool-2 (SCAT2) scores, imaging, discharge instructions, and referral for specialty care. The cohort was analyzed comparing patients evaluated before and after standardization of care. Results Five hundred eighty-nine patients were identified, including 270 before standardization (2007–2011) and 319 after standardization (2011–2012). Statistically significant differences (p < 0.0001) were observed between the 2 groups for multiple variables: there were more girls, more first-time concussions, fewer initial presentations to the emergency department, more consistent administration of the SCAT2, and more consistent supervision of return to play and return to think after adoption of the protocol. Conclusions A combination of increased public awareness and legislation has led to a 5-fold increase in the number of youth athletes presenting for concussion evaluation at the authors' center. Establishment of a multidisciplinary clinic with a standardized protocol resulted in significantly decreased institutional resource utilization and more consistent concussion care for this growing patient population.

Post-destructive eye surgery, associated depression at Sekuru Kaguvi Hospital Eye Unit, Zimbabwe: Pilot Study

2013 ◽  
Vol 72 (2) ◽  
Author(s):  
M. M. Kawome ◽  
R. Masanganise
Keyword(s):  
Cross Sectional Study ◽  
Current Management ◽  
Cross Sectional ◽  
Systematic Random Sampling ◽  
Eye Surgery ◽  
Management Protocol ◽  
Before And After ◽  
Patient Health ◽  
Study Population ◽  
Structured Questionnaire

Destructive eye surgery is associated with more complications than just loss of visual functions of the eye and aesthetics. Currently there is very little published literature on post-destructive eye surgery associated depression. Zimbabwe has been experiencing a surge in the rate of destructive eye surgery done at the National Tertiary Eye Unit. This situation could be churning out lots of unrecognized depressed clients into the community who require assistance in one form or another.Objectives: To determine the prevalence of post-destructive eye surgery associated depression among patients attending Sekuru Kaguvi Hospital Eye Unit and assess if the current management protocol of patients undergoing destructive eye surgery at the Eye Unit addresses the problem adequately.Methods: A cross-sectional study of 28 randomly selected patients who had destructive eye surgeries at Sekuru Kaguvi Hospital was conducted over five months from 1st March 2012 to end of July 2012. A structured questionnaire containing 15 questions on the following items: gender, age, diagnosis, surgical procedure done, expectations before and after surgery, adequacy of counseling given and involvement of family was used to collect data. Nine questions to assess depression were adapted from the Patient Health Questionnaire (PHQ-9).Setting:  The study was conducted at SekuruKaguvi Hospital Eye Unit, Parirenyatwa Group of Hospitals in Harare.Results:  Twenty-eight patients who underwent destructive eye surgery during the study period were selected using systematic random sampling. The gender ratio was 1:1 and the mean age was 38.7 years with a range from 24 to 65 years. Fifty percent of the patients in the study had orbital exenteration while the rest had enucleation (14%) and evisceration (36%). Twenty-eight percent of the study population had depression.Conclusion: Destructive eye surgery is frequently associated with depression and our current management protocol of patients undergoing destructive eye surgery does not address this problem.

A HOSPITAL-BASED CLINICAL STUDY ON THE MANAGEMENT OF CHRONIC MASTOIDITIS AND MASTOID ABSCESS AT VIMS, PAWAPURI, NALANDA, BIHAR

2021 ◽  
pp. 27-29
Author(s):  
Shambhu Sharan Gupta ◽  
Satish Kumar ◽  
Debarshi Jana
Keyword(s):  
Treatment Guidelines ◽  
Demographic Data ◽  
Incision And Drainage ◽  
Best Management ◽  
Management Protocol ◽  
Before And After ◽  
Antibiotics Use ◽  
Data History ◽  
Laboratory Investigations

Background: In spite of the advent of antibiotics, the incidence of mastoiditis and mastoid abscess is not uncommon in the ENT practice. The pathogenesis is due to virulence of organism, insufcient antibiotics use, and ineffective antibiotics. Treatment consists of simple incision drainage to modied radical mastoidectomy. However, there seems to be no unanimous agreement on the best management strategy for this problem. The present study presents the outcome of patients undergoing treatment and also presents a protocol followed in VIMS, Pawapuri, Nalanda, Bihar and its prognostic value. Aim of the Study: The aim of this study is to review the available management protocols for treatment of mastoiditis and mastoid abscess and formulate our own hospital-based guidelines and protocol. Materials and Methods:Astudy was conducted on 53 patients aged between 11 and 60 years, who presented with mastoiditis or mastoid abscess. All the patients were treated according to surgical protocols available. Demographic data, history, and otoscopy ndings were recorded. Patients with mastoiditis were treated with mastoidectomy, and the patients with mastoid abscess were treated initially with incision and drainage and after 2 weeks with mastoidectomy. Laboratory investigations such as audiometry, culture, and sensitivity of pus from the ears were done. All the patients were followed for 6 months. Observations and Results:Atotal of 53 patients were enrolled in this study. Mean age was 25.45 ± 2.35 in males and 23.76 ± 1.85 in females who presented with mastoiditis. Similarly, the mean age was 23.76 ± 1.85 and 20.46 ± 2.10 years for patients of mastoid abscess. There were 39/53 (73.58%) males and 14/53 (26.41%) females. Audiometry could be done in 32/37 (86.48%) patients with mastoiditis and 8/16 (50%) patients with mastoid abscess. These 40/56 (71.42%) patients had conductive deafness with a mean pure tone average of 32.45 dB. There were no post-operative complications reported during follow-up of 6 months. Conclusions:Adenitive management protocol is a must for every hospital to avoid delay and complications before and after surgical treatment in mastoiditis and mastoid abscess. Treatment guidelines should be followed meticulously in the diagnosis, laboratory investigations, and decisionmaking of denitive surgical procedure to be adopted in mastoiditis and mastoid abscess.

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