774 Examination of the Religious and Spiritual Needs of Acutely Injured Burn Patients

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S221-S221
Author(s):  
Carrie A Cox ◽  
Vidhi Javia ◽  
Lisa C Smith ◽  
Rachel C Hill ◽  
C Scott Hultman
Keyword(s):  
Length Of Stay ◽  
Religious Beliefs ◽  
Religious Affiliation ◽  
Full Range ◽  
Religious Involvement ◽  
Spiritual Needs ◽  
Common Mechanism ◽  
Moderate Degree ◽  
Burn Patients ◽  
Burn Care

Abstract Introduction Despite advances in burn care that dramatically increase survivability for severe burn injuries, individuals who suffer such injuries will likely experience long recovery periods complicated by declines in psychological, social, behavioral, occupational, and sexual functioning. We compared the self-importance of spirituality in a patient’s life with select demographic data in order to better understand the role of spirituality in the treatment and recovery of patients in the Burn Intensive Care Unit (BICU). Methods In this survey study and subsequent retrospective review, we explored the importance of spiritual beliefs and practices to the burn patient population within the BICU. We utilized the Belief into Action Scale (BIAC), which is a validated survey tool designed to quantify the full range of an individual’s religious involvement. Each participant completed one BIAC survey during his or her inpatient stay. We then collected patient demographics, including religious affiliation and the number of pastoral visits received. Injury characteristics and outcome measures were examined including, Total Body Surface Area (TBSA) burn, length of stay (LOS), and Charlson Comorbidity Index (CCI). Results Between April and June of 2019, surveys were administered to 32 adult participants. The participants ranged in age from 21 to 83 (mean 52.5), 59% (19/32) were male and 41% (13/32) were female. Of the 32 participants, 69% were Caucasian, 25% were African American, 3% were Hispanic/Latino, and 3% were other. Sixty-six percent (21/32) had no religious affiliation identified within their medical record and 31% (10/32) of patients had at least 1 pastoral visit (range 0–5 visits). TBSA ranged from 0% (10/32) to 35%, seven (22%) participants had an inhalation injury, the most common mechanism of burn injury was flame (43.75%), and the average length of stay was 16 days (range 1–75 days). Mean BIAC score was 44.8 (out of 100), with a median of 46.5 and a standard deviation of 22.6, indicating a moderate degree of spiritual and religious beliefs. Conclusions Acutely injured burn patients, admitted to an urban burn center, report a moderate degree of spiritual and religious beliefs, strongly supporting the need for pastoral care in this population. Applicability of Research to Practice The increased likelihood of survival for severely burn injured patients has led to the need for a greater emphasis on the potential psychological and social morbidity for these individuals. This research highlights the importance of addressing the spiritual needs of burn patients.

Early Enteral Nutrition in Geriatric Burn Patients: Is There a Benefit?

2020 ◽  
Vol 41 (5) ◽  
pp. 986-991
Author(s):  
Lourdes Castanon ◽  
Samer Asmar ◽  
Letitia Bible ◽  
Mohamad Chehab ◽  
Michael Ditillo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Enteral Nutrition ◽  
Early Enteral Nutrition ◽  
Burn Patients ◽  
Improvement Program ◽  
Burn Care ◽  
The Impact ◽  
Complications And Mortality

Abstract Nutrition is a critical component of acute burn care and wound healing. There is no consensus over the appropriate timing of initiating enteral nutrition in geriatric burn patients. This study aimed to assess the impact of early enteral nutrition on outcomes in this patient population. We performed a 1-year (2017) analysis of the American College of Surgeons Trauma Quality Improvement Program and included all older adult (age ≥65 years) isolated thermal burn patients who were admitted for more than 24 hr and received enteral nutrition. Patients were stratified into two groups based on the timing of initiation of feeding: early (≤24 hr) vs late (>24 hr). Multivariate logistic regression was performed to control for potential confounding factors. Outcome measures were hospital and intensive care unit lengths of stay, in-hospital complications, and mortality. A total of 1,004,440 trauma patients were analyzed, of which 324 patients were included (early: 90 vs late: 234). The mean age was 73.9 years and mean TBSA burnt was 31%. Patients in the early enteral nutrition group had significantly lower rates of in-hospital complications and mortality (15.6% vs 26.1%; P = 0.044), and a shorter hospital length of stay (17 [11,23] days vs 20 [14,24] days; P = 0.042) and intensive care unit length of stay (13 [8,15] days vs 17 [9,21] days; P = 0.042). In our regression model of geriatric burn patients, early enteral nutrition was associated with improved outcomes. The cumulative benefits observed may warrant incorporating early enteral nutrition as part of intensive care protocols.

scholarly journals Burn Case Prevalence In Dr Kariadi General Hospital Semarang From 2012 to 2014

2020 ◽  
Vol 7 (2) ◽  
pp. 77-82
Author(s):  
Lucretya Yeniwati Tanuwijaya
Keyword(s):  
General Hospital ◽  
Total Sample ◽  
Moderate Degree ◽  
Burn Patients ◽  
Burn Care ◽  
Burn Prevention ◽  
Skilled Personnel ◽  
Common Etiology ◽  
Male Patients ◽  
Severe Degree

Background: Burns is a type of trauma that requires treatment and rehabilitation, which is still difficult and requires perseverance, a high amount of costs, and trained and skilled personnel. Morbidity and mortality of burns are relatively high, especially in developing countries where burn prevention and treatment systems are inadequate. The prevalence of burns is expected to be an advantage for the development of science in further research and could help clinicians prevent and curative burn care efforts. Method: The study subjects were burned patients examined and hospitalized at Dr. Kariadi General Hospital, Semarang. Data from each sample's clinical examination results were then collected to be described based on gender, age, burns degree criteria, and etiology of burns. Results: The total sample obtained was 72 samples, including 61 patients (85.53%) with new burns and 11 non-emergency patients (14.47%). From a total of 61 new burn patients, eight female patients (13.11%) and 53 male patients (86.89%) were obtained; 10 patients (16.40%) were children (0-18 years), 50 (81.96%)were adults (18-65), and one patient (1.64%) belonged to geriatric (> 65 years) ); based on the degree of the burns, seven patients (11.48%) had a moderate degree and 54 patients (88.52%) had a severe degree; there were 28 patients (45.90%) who suffered burns caused by fire, 20 patients (32.79%) due to electricity, six patients (9.84%) caused by scald, and seven patients (11.47 %) with an unknown cause. Of the 61 new burn patients, there were five patients (8.20%) who died. Conclusion: Burn prevalence in Dr. Kariadi General Hospital, Semarang in 2012-2014 are mostly experienced by men, adults, with severe burn criteria, with the most common etiology is fire.  

scholarly journals Spiritual Care of the Sick

2017 ◽  
Vol 84 (3) ◽  
pp. 220-225 ◽  
Author(s):  
Fr. Juan R. Vélez
Keyword(s):  
Spiritual Care ◽  
Religious Beliefs ◽  
Religious Affiliation ◽  
Spiritual Healing ◽  
Spiritual Needs ◽  
To Receive

In the Gospel we see how people bring the sick to Christ to be healed. As physicians, nurses, and chaplains we are God's instruments bringing physical and spiritual healing to the sick. It is important for those of us who care for the sick to ask them about their religious affiliation and spiritual needs, and then following their cues and in a respectful way to encourage them to pray and, in the case of Catholics, to receive the sacraments. We should also pray for our patients, and when we think they would like it, to pray with them. Summary Physicians and nurses, not only chaplains, should ask patients about their religious beliefs, offer to find spiritual assistance for them, and when appropriate pray with them.

656 Autologous Skin Cell Suspension is Associated with Decreased Hospital Length of Stay and Limited Surgical Interventions

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S194-S194
Author(s):  
Nicole M Kopari ◽  
Yazen Qumsiyeh
Keyword(s):  
Length Of Stay ◽  
Cell Suspension ◽  
Average Length ◽  
Total Body Surface Area ◽  
Hospital Length ◽  
Care Quality ◽  
Hospital Length Of Stay ◽  
Burn Patients ◽  
Burn Care ◽  
Skin Cell

Abstract Introduction Hospital length of stay is a measure of burn care quality and resource allocation. Traditionally, the average length of stay (LOS) for patients with burns is estimated at 1 day/% total body surface area (TBSA) although the 2016 American Burn Association National Burn Repository predicts closer to 3 days/%TBSA. Recent literature has shown that application of autologous skin cell suspension (ASCS) is associated with decreased hospital LOS and therefore is considered economically advantageous. Our study evaluated the LOS as it related to TBSA as well as the number of operations in patients treated with ASCS. Methods This is a single institution, retrospective review of burn patients at an American Burn Associated verified burn center admitted from August 2019 - August 2020 who underwent epidermal autografting. Patients were treated for partial thickness and full thickness burns either with epidermal grafting alone or in combination with widely meshed skin grafting. Demographics included age and sex of patient. The TBSA, LOS, number of operations, and re-admission rates were also collected. Results A total of 52 patients were included in the review. 73% were male with an average age of 42 years (range 15 months to 88 years. The patients were stratified into 4 different categories based on their burn TBSA: 0-10% (n=25), 11-20% (n=16), 21-30% (n=5), and >30% (n=6). The average number of operations increased with %TBSA (0-10%=1, 11-20%=1, 21-30%=2, >30%=4). The average LOS overall was 0.9 days/%TBSA (0-10%=1.0, 11-20%=0.7, 21-30%=0.9, >30%=0.8). Only one patient required re-admission after the first dressing takedown and underwent a second application of ASCS with subsequent healing. No patients required reconstructive surgery. Conclusions Burn patients treated with ASCS continue to demonstrate a decreased LOS/%TBSA and an overall decrease in the number of operations. The most significant impact may be noted as burn size increases.

Religion and depression: a review of the literature

Twin Research ◽  
1999 ◽  
Vol 2 (2) ◽  
pp. 126-136 ◽  
Author(s):  
Michael E McCullough ◽  
David B Larson
Keyword(s):  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Religious Beliefs ◽  
Longitudinal Research ◽  
Religious Affiliation ◽  
Religious Involvement ◽  
Elevated Risk ◽  
Religious Motivation ◽  
Religious Salience ◽  
Increased Risk

AbstractWe reviewed data from approximately 80 published and unpublished studies that examined the association of religious affiliation or involvement with depressive symptoms or depressive disorder. In these studies, religion was measured as religious affiliation; general religious involvement; organizational religious involvement; prayer or private religious involvement; religious salience and motivation; or religious beliefs. People from some religious affiliations appear to have an elevated risk for depressive symptoms and depressive disorder, and people with no religious affiliation are at an elevated risk in comparison with people who are religiously affiliated. People with high levels of general religious involvement, organizational religious involvement, religious salience, and intrinsic religious motivation are at reduced risk for depressive symptoms and depressive disorders. Private religious activity and particular religious beliefs appear to bear no reliable relationship with depression. People with high levels of extrinsic religious motivation are at increased risk for depressive symptoms. Although these associations tend to be consistent, they are modest and are substantially reduced in multivariate research. Longitudinal research is sparse, but suggests that some forms of religious involvement might exert a protective effect against the incidence and persistence of depressive symptoms or disorders. The existing research is sufficient to encourage further investigation of the associations of religion with depressive symptoms and disorder. Religion should be measured with higher methodological standards than those that have been accepted in survey research to date.

scholarly journals A 3-Year Review of an Outpatient Burn Sedation Program in a Tertiary Burn Care Centre: Is It Safe and Does It Work?

2019 ◽  
Vol 27 (4) ◽  
pp. 305-310
Author(s):  
Rayleigh Chan ◽  
Aaron C. Van Slyke ◽  
Marija Bucevska ◽  
Cynthia Verchere
Keyword(s):  
Adverse Events ◽  
Deep Sedation ◽  
Tertiary Care ◽  
Common Mechanism ◽  
Burn Patients ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Burn Treatment ◽  
Burn Care ◽  
Treatment Room

Introduction: The burn treatment room at our tertiary-care centre is run by a multidisciplinary team, providing care to primarily burn patients who require moderate to deep sedation to undergo dressing changes in a monitored setting outside the operating room. There is little literature on the safety, efficacy, and logistics of treating outpatient pediatric burn patients in this manner. This study reviews the safety of deep sedation in the burn treatment room. Methods: A retrospective chart review of patients with burns treated in the burn treatment room from 2013 to 2015 was conducted. Patient demographics, diagnosis, procedure details, sedation, and adverse events were recorded. Data were analyzed descriptively. Results: Sevety-four patients with burns had a total of 308 visits in the burn treatment room for burn bath and/or dressing changes. Scald burns were the most common mechanism of injury (n = 56). Most burns were superficial and mid-dermal (54%), initially estimated at 5% to 10% TBSA (50%). Of the 308 visits, 304 required sedation. Adverse events were recorded in 11 (3.6%) of 304 sedated procedures. None of these events were critical: 7 patients required intravenous conversion due to inadequate oral sedation, 2 experienced brief apnea episodes but recovered spontaneously, and 2 had delayed discharge of more than 2 hours due to residual sedation. Conclusion: The burn treatment room is a safe and effective setting for treating pediatric burn patients, bypassing what might historically require operating suite inpatient management.

775 The Spiritual and Religious Beliefs and Needs of Burn Reconstruction Patients

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S221-S222
Author(s):  
Laurel Wood ◽  
C Scott Hultman
Keyword(s):  
Religious Beliefs ◽  
Statistical Significance ◽  
Psychiatric Morbidity ◽  
Outpatient Setting ◽  
Surgical Reconstruction ◽  
Spiritual Needs ◽  
Burn Patients ◽  
Common Procedure ◽  
The Impact ◽  
Over Time

Abstract Introduction Acutely injured burn patients demonstrate a range of spiritual and religious needs, but little is known about the variability of their beliefs over time, as well as the impact of reconstruction on these spiritual and religious beliefs. We examined the faith needs of burn reconstruction patients over the course of their reconstruction. Methods After obtaining consent, we assessed the spiritual and religious beliefs of 34 burn patients who were referred to Plastic Surgery for reconstruction, using the validated Belief into Action Scale (BIAC), which measures strength of beliefs on a scale from 10 to 100. A Likert scale from 1 to 10 was used to evaluate spiritual needs. Patients were reassessed 2 years later by telephone interview, after the majority of had completed their reconstruction. We compared before and after BIAC scores, including subscales, using paired Student’s T tests, with p< 0.05 assigned statistical significance. Results BIAC scores increased from 43.6 to 45.6 (p< 0.05) in burn reconstruction patients, over a period of two years. The only subscale that was statistically different was “conforming your life to the teaching of your faith,” which increased from 5.8 to 6.8 (p< 0.05). Burn reconstruction patients reported the importance of their spirituality as a 7.6, the importance of spirituality in reconstruction as a 6.0, and meeting their spiritual needs as 8.6. Regarding demographics of these patients, mean age was 48.3 years, mean time from injury to reconstruction was 1.9 years, gender ratio was 17:17, mean TBSA was 12.4%, and 14/34 had significant neuro-psychiatric illness. 21/34 patients underwent some form of surgical reconstruction, with laser resurfacing of hypertrophic scars the most common procedure (n=16). Conclusions The spiritual and religious beliefs of burn reconstruction patients appear to strengthen over time, despite significant challenges that these patients encounter, either from their initial injury or concurrent neuro-psychiatric morbidity. Meeting these needs in the outpatient setting, through pastoral care and/or the local church community, may further enhance recovery. Applicability of Research to Practice Identifying the spiritual and religious needs of burn patients may enhance recovery from injury.

The Impact of No Next of Kin Decision Makers on End-of-Life Care

2020 ◽  
Author(s):  
Ryan K Ota ◽  
Maxwell B Johnson ◽  
Trevor A Pickering ◽  
Warren L Garner ◽  
T Justin Gillenwater ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Surface Area ◽  
Body Surface ◽  
Total Body Surface Area ◽  
Burn Patients ◽  
Next Of Kin ◽  
Medical Decisions ◽  
Comfort Care ◽  
Burn Care ◽  
Total Body

Abstract For critically ill burn patients without a next of kin, the medical team is tasked with becoming the surrogate decision maker. This poses ethical and legal challenges for burn providers. Despite this frequent problem, there has been no investigation of how the presence of a next of kin affects treatment in burn patients. To evaluate this relationship, a retrospective chart review was performed on a cohort of patients who died during the acute phase of their burn care. Variables collected included age, gender, length of stay, total body surface area, course of treatment, and presence of a next of kin. In total, 67 patients met the inclusion criteria. Of these patients, 14 (21%) did not have a next of kin involved in medical decisions. Patients without a next of kin were significantly younger (P = .02), more likely to be homeless (P < .01), had higher total body surface area burns (P = .008), had shorter length of stay (P < .001), and were five times less likely to receive comfort care (P = .01). Differences in gender and ethnicity were not statistically significant. We report that patients without a next of kin present to participate in medical decisions are transitioned to comfort care less often despite having a higher burden of injury. This disparity in standard of care demonstrates a need for a cultural shift in burn care to prevent the suffering of these marginalized patients. Burn providers should be empowered to reduce suffering when no decision maker is present.

scholarly journals Early Excision and Grafting in Burns: An Experience in a Tertiary Care Industrial Hospital of Eastern India

2019 ◽  
Vol 52 (03) ◽  
pp. 337-342
Author(s):  
Prasenjit Goswami ◽  
Seelora Sahu ◽  
Pankaj Singodia ◽  
Manjeet Kumar ◽  
Tukulu Tudu ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Burn Injury ◽  
Tertiary Care ◽  
Total Body Surface Area ◽  
Burn Patients ◽  
Cost Of Treatment ◽  
Outcome Parameters ◽  
Burn Care ◽  
Significant Difference ◽  
The Cost

Abstract Introduction To compare the burn patients undergoing early excision and grafting (within 7 days of burn injury) with the patients undergoing late surgeries (more than 7 days after burn injury) to see if there was any difference in surgical and outcome parameters including length of stay, expenditure, and overall outcome of the patients. Material and Methods A retrospective analysis of the data collected from the burn care unit records over a period of one year was done. Fifty-eight patients who matched with our inclusion criteria were divided into two groups. An early excision group who underwent surgery within 7 days of sustaining burn injury (n = 24) and a late excision group who underwent excision and grafting/debridement after 7 days of sustaining burn (n = 34). Data recorded included demographic variables like age, sex, percentage total body surface area (TBSA) burn; nature of burn; date of sustaining burn; date of admission to the burn care unit; and treatment and outcome parameters like date of surgery, days from burn injury to first surgery, number of surgeries, type of surgery, percentage of TBSA resurfaced with skin graft, blood products used, length of stay, outcome, and total expenditure incurred by patients. Results There was no statistically significant difference in the number of surgeries done, the units of packed cell used, and the number of fresh frozen plasma (FFP) used between the early excision group and the late excision group. The length of stay was significantly low in the early excision group as compared with the late excision group. The expenditure incurred in the treatment of the early excision group was significantly lower than the cost of treatment of the late excision group. Conclusion Early excision and grafting in burn cases reduces the length of the stay of burn patients and, in turn, reduces the cost of treatment. However, having a dedicated burn care unit is important for the hospitals and both public and private hospitals should make a move in that direction.

750 Burn Injury in Our Region’s Indigenous Population

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S208-S209
Author(s):  
Lindsay Wainwright ◽  
Tanis Quaife ◽  
Saul Magnusson ◽  
Sarvesh Logsetty
Keyword(s):  
Length Of Stay ◽  
Indigenous People ◽  
Indigenous Population ◽  
Burn Injuries ◽  
Indigenous Populations ◽  
Observation Data ◽  
Burn Patients ◽  
Unique Challenge ◽  
Burn Care ◽  
Burn Survivors

Abstract Introduction Our Indigenous population is disproportionately affected by injury resulting in significant morbidity and mortality. Burn injuries in this population have not yet been explored. Barriers to healthcare faced by Indigenous people differ from non-Indigenous people and understanding these differences is essential to providing culturally safe care. Our research seeks to understand the characteristics of burns in our Indigenous population and the personal experiences of Indigenous burn survivors. Our aim is to raise awareness about the specialized needs of this population and provide cultural understanding to inform in-hospital care and repatriation to home communities. Methods Data was collected from our regional burn unit to examine burn characteristics between Indigenous and non-Indigenous burn survivors. The combined adult and pediatric burn registries were examined. Between 2008–2018 there were 615 complete observation data sets. Observations were grouped by Indigenous status, age, and urban/rural. Summary tables were constructed and t-tests performed to examine differences in burn severity and length of stay between the groups of interest. Results Indigenous burn patients in our region are younger at the time of injury and while they have a similar TBSA, their length of stay is considerably longer. Conclusions Burn injuries in the Indigenous population account for 25% of all admissions. Despite a similar burn size their injuries result in significantly longer stays in hospital. This may be because Indigenous burn patients are more likely to live in rural/remote settings far from specialized burn care compared to non-Indigenous patients. The distance from definitive care may the reason for the longer length of stay. Being far from their home community while in hospital is a unique challenge in this population. Future plans are to gain a better understanding of Indigenous burn patients and their barriers to care by completing a qualitative narrative analysis on Indigenous burn survivor healthcare experiences. This information will inform burn patient care in hospital and repatriation to home communities. Applicability of Research to Practice Burns are prevalent in Indigenous populations and understanding their experiences supports culturally competent care. The distance from definitive care seems to increase length of stay independent of the size of burn. This research aims to better understand this population so that we may better serve Indigenous burn patients.

Sign in / Sign up

Export Citation Format

Share Document