Postoperative Management After Tracheostomy and Laryngectomy: Improving Nursing Knowledge With Bedside Posters

This study sought to improve nursing staff understanding regarding the differences in postoperative management between patients who have undergone tracheostomy and laryngectomy. The intervention involved a brief didactic session followed by the placement of an informative poster and anatomic diagram above the bed of tracheostomy and laryngectomy patients over a 6-month period. Data were collected before and after the didactic session and poster implementation. Of the 50 nurses surveyed, 32% believed oral ventilation is appropriate for laryngectomy patients compared to 0% of nurses after the intervention. The percentage of nursing staff reporting self-assessed clear understanding of the patient care differences between laryngectomy and tracheostomy improved after the intervention. The use of informational posters and didactic sessions significantly improves nursing staff understanding of the differences between tracheostomy and laryngectomy patients. Level of Evidence: IV

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Manejo da dor em punção venosa pediátrica: um pacote de medidas

Revista Recien - Revista Científica de Enfermagem ◽

10.24276/rrecien2021.11.33.157-168 ◽

2021 ◽

Vol 11 (33) ◽

pp. 157-168

Author(s):

Larissa Grispan e Silva Guimarães ◽

Natália Shinkai Binotto ◽

Stela Faccioli Ederli ◽

Mauren Teresa Grubisich Mendes Tacla

Keyword(s):

Pain Management ◽

Patient Care ◽

Nursing Staff ◽

Professional Growth ◽

Management Strategies ◽

Care Bundle ◽

Evidence Based ◽

Topical Anesthetic ◽

Care Research ◽

Before And After

Apresentar o processo de elaboração de um pacote de medidas para manejo da dor de crianças submetidas à punção venosa pela equipe de enfermagem. Pesquisa Convergente Assistencial, do tipo antes e após intervenção, realizada com a equipe de enfermagem de uma unidade pediátrica do sul do Brasil. Elaboração de pacote de medidas com seis estratégias selecionadas pela equipe de enfermagem a serem utilizadas antes e durante a punção venosa: preparo da criança e/ou acompanhante, posicionamento da criança, distração, amamentação, solução adocicada associada ou não à sucção não nutritiva e anestésico tópico. Os participantes manifestaram satisfação quanto ao modo de elaboração do mesmo, destacando a contribuição deste para seu crescimento profissional. O pacote de medidas otimizou a adoção das estratégias para manejo da dor. A Pesquisa Convergente Assistencial alicerçada na prática baseada em evidências mostrou-se adequada, visto que propiciou a aplicação de achados científicos no cenário assistencial considerando suas particularidades.Descritores: Manejo da Dor, Criança, Cateterismo Periférico, Enfermagem Baseada em Evidências. Management of pediatric venipuncture pain: a package of measuresAbstract: To present the process of elaboration of a patient care package for pain management in children undergoing venipuncture by the nursing staff. Convergent Care Research, before and after intervention, conducted with the nursing staff of a southern pediatric unit in Brazil. Patient care packege with six strategies, selected by the nursing staff, to be used before and during venipuncture: preparation of the child and/or companion, child positioning, distraction, breastfeeding, sweet-tasting solution with or without non-nutritive suction and topical anesthetic usage. The package of measures optimized the adoption of pain management strategies, highlighting its contribution to their professional growth. The patient care bundle optimized the adoption of strategies for pain management. The Convergent Care Research grounded in evidence-based practice showed appropriate, since it allowed the application of scientific findings in the care setting, considering its peculiarities.Descriptors: Pain Management, Child, Catheterization, Peripheral, Evidence-Based Nursing. Manejo del dolor de la venopunción pediátrica: un paquete de medidasResumen: Presentar el proceso de elaboración de un paquete de medidas para manejo del dolor de niños sometidos a la venopunción por el equipo de enfermería. Investigación Convergente Asistencial, del tipo antes y después de la intervención, realizada con el equipo de enfermería de una unidad pediátrica en el sur de Brasil. Paquete de medidas con seis estrategias seleccionadas por el equipo de enfermería que deben ser utilizadas antes y durante la venopunción: preparación del niño y/o acompañante, posicionamiento del niño, distracción, amamantamiento, solución dulce asociada o no a succión no nutritiva y anestésica tópica. Los participantes manifestaron satisfacción en cuanto al modo de elaboración del mismo, destacando la contribución de este para su crecimiento profesional. El paquete de medidas optimizó la adopción de estrategias para manejo del dolor. La Investigación Convergente Asistencial cimentada en la práctica basada en evidencias se mostró adecuada, visto que propició la aplicación de hallazgos científicos en el escenario asistencial considerando sus particularidades.Descriptores: Manejo del Dolor, Niño, Cateterismo Periférico, Enfermería Basada en la Evidencia.

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Nursing education in humanized care

Escola Anna Nery ◽

10.1590/2177-9465-ean-2017-0275 ◽

2018 ◽

Vol 22 (1) ◽

Author(s):

Luz Esperanza Hernández Terrazas ◽

Aracely Díaz Oviedo ◽

Jose Francisco Martínez Licona ◽

Darío Gaytan Hernandez

Keyword(s):

Nursing Education ◽

Educational Intervention ◽

Nursing Staff ◽

Public Hospital ◽

Test Results ◽

Nursing Knowledge ◽

Parametric Test ◽

The Third ◽

Before And After ◽

Level Of Knowledge

Abstract Objective: To evaluate the effect of an educational intervention for the adequate use of the Dignified Treatment indicator by the nursing staff before the care of hospitalized patients. Methods: Pre-experimental analysis performed from February to March of 2017 in a public hospital in San Luis Potosí Mexico, with 37 nurses. In the first stage, a diagnostic evaluation of knowledge was elaborated. In the second, an education program was implemented for the proper use of the decent treatment indicator. In the third, nursing knowledge was evaluated and the before and after tests were compared by the t-Student parametric test. Results: For the diagnostic stage, 97% of nursing staff had a low level of knowledge. After implementing the program, 80% of the team increased their level. Conclusions: The educational intervention increased the knowledge about the use of the Dignified Treatment indicator.

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Linking the Unitary Paradigm to Policy through a Synthesis of Caring Science and Integrative Nursing

Nursing Science Quarterly ◽

10.1177/0894318417708415 ◽

2017 ◽

Vol 30 (3) ◽

pp. 262-268 ◽

Cited By ~ 6

Author(s):

Mary S. Koithan ◽

Mary Jo Kreitzer ◽

Jean Watson

Keyword(s):

Patient Care ◽

Healthcare System ◽

Care Delivery ◽

Healthcare Policy ◽

Patient Centered ◽

Nursing Knowledge ◽

Call To Action ◽

Caring Science ◽

Patient Care Delivery

The principles of integrative nursing and caring science align with the unitary paradigm in a way that can inform and shape nursing knowledge, patient care delivery across populations and settings, and new healthcare policy. The proposed policies may transform the healthcare system in a way that supports nursing praxis and honors the discipline’s unitary paradigm. This call to action provides a distinct and hopeful vision of a healthcare system that is accessible, equitable, safe, patient-centered, and affordable. In these challenging times, it is the unitary paradigm and nursing wisdom that offer a clear path forward.

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Changes to Eye Whiteness and Eyelid/Brow Position With Topical Oxymetazoline in Aesthetic Patients

Aesthetic Surgery Journal ◽

10.1093/asj/sjab400 ◽

2021 ◽

Author(s):

Shoaib Ugradar ◽

Jane S Kim ◽

Noelle Trost ◽

Emanuil Parunakian ◽

Erin Zimmerman ◽

...

Keyword(s):

Color Change ◽

Color Space ◽

Ophthalmic Solution ◽

The United States ◽

Lower Eyelid ◽

Secondary Outcome ◽

Level Of Evidence ◽

Upper Eyelid ◽

Before And After ◽

The Mean

Abstract Background Oxymetazoline hydrochloride 0.1% ophthalmic solution has recently been approved in the United States for the treatment of ptosis. Objectives The aim of this study was to assess the upper and lower eyelid position as well as the brow position and the color of the sclera following the ophthalmic administration of oxymetazoline hydrochloride 0.1%. Methods In this prospective cohort study, consecutive patients presenting with ptosis received topical oxymetazoline 0.1%. The primary outcome was measurement of the upper eyelid height (margin-to-reflex distance 1 [MRD1]) and lower eyelid height (MRD2) relative to the center of pupil, along with assessment of brow height, measured on photographs at baseline and 2 hours after instillation of oxymetazoline. The secondary outcome was the assessment of the color of the sclera (eye whiteness) before and after treatment with a novel color space algorithm. Results Twenty-nine patients participated in the study. The mean [SD] MRD1 at baseline was 2.3 [0.6] mm. At 2 hours following oxymetazoline treatment, the mean MRD1 significantly increased to 4.2 [0.9] mm (P < 0.01). The mean MRD2 also significantly increased from 5.3 [0.9] mm to 5.7 [1.0] mm (P < 0.01). Brow position did not change with treatment (P = 0.4). Following treatment, the eye sclera became significantly whiter, with a mean ΔEab (color change) of 9.7 [3.9], with 57 out of 58 eyes experiencing a significant change in color. A change of ΔEab ≥2 is considered visually perceptible to the human eye. Conclusions Within 2 hours of use, oxymetazoline significantly improves the size of the palpebral aperture (MRD1 + MRD2) and also makes the eye appear significantly whiter. Level of Evidence: 4

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LOW-LOAD RESISTANCE EXERCISE IMPROVES COGNITIVE FUNCTION IN OLDER ADULTS

Revista Brasileira de Medicina do Esporte ◽

10.1590/1517-869220182402179200 ◽

2018 ◽

Vol 24 (2) ◽

pp. 125-129 ◽

Cited By ~ 2

Author(s):

Amanda Veiga Sardeli ◽

Marina Lívia Venturini Ferreira ◽

Lucas do Carmo Santos ◽

Marília de Souza Rodrigues ◽

Alfredo Damasceno ◽

...

Keyword(s):

Older Adults ◽

Response Time ◽

Resistance Exercise ◽

Load Resistance ◽

Level Of Evidence ◽

Healthy Older Adults ◽

Results Of Treatment ◽

Low Load ◽

Before And After ◽

Exercise Induced

ABSTRACT Introduction: Resistance exercise (RE) training is widely recommended for increasing muscle strength and mass in older adults. RE is also a potential stimulus to improve cognitive functions (CF), but the best protocol for this purpose is unknown. Objective: To compare the effects of different RE protocols on CF in the same group of individuals. Methods: Twenty-four older adults were randomized (cross over) to control (CON) and lower limb RE protocols with high load (HL - 80% of 1RM), low load (LL - 30% of 1RM) and LL with blood flow restriction (LL-BFR - 30% of 1RM and 50% BFR). For CF assessment, participants underwent the Stroop test before and after each RE protocol. Results: Reduction in response time for Stroop neutral stimuli was greater after LL (effect size (ES) = -0.92) compared to CON (ES = -0.18) and HL (ES = -0.03), but was not different from LL-BFR (ES = -0.24). The reduced response time was associated with reduced parasympathetic modulation and increased cardiac output across protocols. Conclusion: LL was the most effective RE protocol to improve CF of older adults and a potential beneficial effect of LL-BFR on CF (non-significant) was identified. Therefore, LL resistance exercise appears to stimulate acute cognitive improvements in healthy older adults, probably through exercise-induced optimal autonomic modulation changes. Level of Evidence I; Therapeutic studies-Investigating the results of treatment.

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Effects of high-fidelity simulation education on medical students’ anxiety and confidence

PLoS ONE ◽

10.1371/journal.pone.0251078 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0251078

Author(s):

Ji Hye Yu ◽

Hye Jin Chang ◽

Soon Sun Kim ◽

Ji Eun Park ◽

Wou Young Chung ◽

...

Keyword(s):

Clinical Practice ◽

Medical Students ◽

Patient Care ◽

Clinical Setting ◽

Clinical Performance ◽

High Fidelity ◽

High Fidelity Simulation ◽

Simulation Education ◽

Before And After ◽

Care Situation

Introduction Psychological factors such as anxiety and confidence that students have in the patient care situation are important in that this affects the actual clinical performance. Students who are just starting clinical practice have a lack of clinical knowledge, skill proficiency, and patient communication skills, so they experience anxiety and lack of confidence in clinical setting. Practice in a safe environment, such as simulation education, can help students perform more settled and competently in patient care. The purpose of this study was to analyze the effect of high-fidelity simulation experience on anxiety and confidence in medical students. Materials and methods This study enrolled 37 5th-year students at Ajou University School of Medicine in 2020. Two simulation trainings were implemented, and a survey was conducted to measure students’ level of anxiety and confidence before and after each simulation. Based on the research data, a paired t-test was conducted to compare these variables before and after the simulation, and whether this was their first or second simulation experience. Results Students had a significantly lower level of anxiety and a significantly higher level of confidence after the simulation than before. In addition, after one simulation experience, students had less anxiety and more confidence before the second simulation compared to those without simulation experience. Conclusions We confirmed that medical students need to be repeatedly exposed to simulation education experiences in order to have a sense of psychological stability and to competently deliver medical treatment in a clinical setting. There is a practical limitation in that medical students do not have enough opportunities to meet the patients during clinical practice in hospitals. Therefore, in order to produce excellent doctors, students should have the expanded opportunities to experience simulation education so they can experience real-world medical conditions.

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The Role of Endothelial Dysfunction in the Development of Cardiotoxic Action of Cytostatics in Patients with Lymphoproliferative Diseases

Kardiologiia ◽

10.18087/cardio.2019.4.10251 ◽

2019 ◽

Vol 59 (4) ◽

pp. 64-66 ◽

Cited By ~ 2

Author(s):

D. A. Budanova ◽

Yu. N. Belenkov ◽

I. Ya. Sokolova ◽

O. N. Antyufeeva ◽

V. I. Ershov ◽

...

Keyword(s):

Endothelial Dysfunction ◽

Normal Values ◽

Clear Understanding ◽

Age Group ◽

Lymphoproliferative Diseases ◽

Endothelin 1 ◽

Vasoconstrictor Effect ◽

Before And After ◽

Chemotherapy Cardiotoxicity

Understanding mechanisms of chemotherapy cardiotoxicity is an important problem due to the lack of clear understanding of its occurrence. Development of endothelial dysfunction is considered to be one of possible ways in implementation of these side effects. The analysis of endothelin-1 and e-selectin levels in 26 patients with lymphoproliferative diseases before and after the completion of the treatment program was been performed. The results of the study showed normal values of E-selectin level and increased level of endothelin-1 in the whole group of patients before treatment. After completion of chemotherapy program, in the whole group, there was a decrease of these two markers. However, values of level of endothelin-1 with vasoconstrictor effect remained high even after the end of therapy. It is imp ortant that at detailed analysis the dynamics of investigated markers in patients of older age group (median age 64 years) was associated with worsening of endothelial dysfunction.

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Conventional versus Smart Wireless Navigation in Total Knee Replacement: Similar Outcomes in a Randomized Prospective Study

Joints ◽

10.1055/s-0038-1660813 ◽

2018 ◽

Vol 06 (02) ◽

pp. 090-094 ◽

Cited By ~ 2

Author(s):

Matteo Denti ◽

Francesco Soldati ◽

Francesca Bartolucci ◽

Emanuela Morenghi ◽

Laura De Girolamo ◽

...

Keyword(s):

Statistical Significance ◽

Tibial Slope ◽

Computer Assisted ◽

Level Of Evidence ◽

Assisted Navigation ◽

Level Ii ◽

Before And After ◽

Total Knee ◽

Generation Computer ◽

Navigated Tka

Purpose The development of new computer-assisted navigation technologies in total knee arthroplasty (TKA) has attracted great interest; however, the debate remains open as to the real reliability of these systems. We compared conventional TKA with last generation computer-navigated TKA to find out if navigation can reach better radiographic and clinical outcomes. Methods Twenty patients with tricompartmental knee osteoarthritis were prospectively selected for conventional TKA (n = 10) or last generation computer-navigated TKA (n = 10). Data regarding age, gender, operated side, and previous surgery were collected. All 20 patients received the same cemented posterior-stabilized TKA. The same surgical instrumentation, including alignment and cutting guides, was used for both the techniques. A single radiologist assessed mechanical alignment and tibial slope before and after surgery. A single orthopaedic surgeon performed clinical evaluation at 1 year after the surgery. Wilcoxon's test was used to compare the outcomes of the two groups. Statistical significance was set at p < 0.05. Results No significant differences in mechanical axis or tibial slope was found between the two groups. The clinical outcome was equally good with both techniques. At a mean follow-up of 15.5 months (range, 13–25 months), all patients from both groups were generally satisfied with a full return to daily activities and without a significance difference between them. Conclusion Our data showed that clinical and radiological outcomes of TKA were not improved by the use of computer-assisted instruments, and that the elevated costs of the system are not warranted. Level of Evidence This is a Level II, randomized clinical trial.

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Standardizing preoperative preparation to reduce surgical site infections among pediatric neurosurgical patients

Journal of Neurosurgery Pediatrics ◽

10.3171/2016.10.peds16287 ◽

2017 ◽

Vol 19 (4) ◽

pp. 399-406 ◽

Cited By ~ 7

Author(s):

Joshua K. Schaffzin ◽

Katherine Simon ◽

Beverly L. Connelly ◽

Francesco T. Mangano

Keyword(s):

Surgical Site Infections ◽

Pediatric Neurosurgery ◽

Postoperative Management ◽

Neurosurgical Procedure ◽

Protocol Adherence ◽

Protocol Development ◽

Published Evidence ◽

Neurosurgical Patients ◽

Before And After ◽

Prevention Protocol

OBJECTIVE Surgical site infections (SSIs) are costly to patients and the health care system. Pediatric neurosurgery SSI risk factors are not well defined. Intraoperative protocols have reduced, but have not eliminated, SSIs. The effect of preoperative intervention is unknown. Using quality improvement methods, a preoperative SSI prevention protocol for pediatric neurosurgical patients was implemented to assess its effect on SSI rate. METHODS Patients who underwent a scheduled neurosurgical procedure between January 2014 and December 2015 were included. Published evidence and provider consensus were used to guide preoperative protocol development. The Model for Improvement was used to test interventions. Intraoperative and postoperative management was not standardized or modified systematically. Staff, family, and overall adherence was measured as all-or-nothing. In addition, SSI rates among eligible procedures were measured before and after protocol implementation. RESULTS Within 4 months, overall protocol adherence increased from 51.3% to a sustained 85.7%. SSI rates decreased from 2.9 per 100 procedures preintervention to 0.62 infections postintervention (p = 0.003). An approximate 79% reduction in SSI risk was identified (risk ratio 0.21, 95% CI 0.08–0.56; p = 0.001). CONCLUSIONS Clinical staff and families successfully collaborated on a standardized preoperative protocol for pediatric neurosurgical patients. Standardization of the preoperative phase of care alone reduced SSI rates. Attention to the preoperative in addition to the intraoperative and postoperative phases of care may lead to further reduction in SSI rates.

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