INFORMATION NEEDS OF DIGESTIVE TRACT SURGERY PATIENTS BEFORE AND AFTER THE SURGERY: AN EXPLORATORY STUDY OF WESTERN LITHUANIA

2019 ◽  
Vol 4 ◽  
pp. 154
Author(s):  
Lina Gedrime ◽  
Natalja Istomina-Fatkulina ◽  
Indre Brasaite ◽  
Sanna Salanterä
Keyword(s):  
Digestive Tract ◽  
Nursing Care ◽  
Information Needs ◽  
Wound Care ◽  
Gastrointestinal Surgery ◽  
Care Practice ◽  
Post Surgery ◽  
Lack Of Information ◽  
Before And After ◽  
Fear And Anxiety

The aim of this study was to describe the information needs of patients undergoing gastrointestinal surgery in Western Lithuania. Methods. This data were collected from patients of three Klaipeda city hospitals performing digestive tract surgeries in January – March 2015. The interview responses (n = 86) were analyzed inductively with thematic content analysis. Results. The interview revealed lack of information about disease, treatment and nursing care. The participants expressed fear and worries about their forthcoming surgery, anesthesia, pain, the ways of pain management, possible complications and their prevention as well as the future concerning their disease in general. Conclusions. The results show that the participants had not got enough information about treatment, nursing, anesthesia, rehabilitation, wound care or about post-surgery period. Instead they felt fear and anxiety. The participants were not included into treatment and nursing processes. According to the participants’ responses, the information needs were different before and after the surgery. Lack of information prevents patients from acting self-dependently in their care. Practice implications. Patient oriented approach to patient education and innovative ways of information delivery are needed in Lithuanian nursing care of patient’s having a gastrointestinal surgery. 

scholarly journals Information needs of digestive tract surgery patients before and after surgery: an exploratory study of western Lithuania.

2019 ◽  
Vol 13 (1) ◽  
pp. 14-16
Author(s):  
Lina Gedrime ◽  
Natalja Istomina-Fatkulina ◽  
Indre Brasaite ◽  
Sanna Salanterä
Keyword(s):  
Digestive Tract ◽  
Information Needs ◽  
Wound Care ◽  
Gastrointestinal Surgery ◽  
Background Information ◽  
Post Surgery ◽  
Lack Of Information ◽  
Operative Care ◽  
Before And After ◽  
Fear And Anxiety

Background: Information has a distinct value for operative care from the perspective of both the patient and the professional. Aim of the study: The aim of this study was to describe the information needs of patients undergoing gastrointestinal surgery in western Lithuania. Material and methods: The data was collected from patients at three Klaipeda city hospitals performing digestive tract surgeries from January through March 2015. The interview responses (n = 86) were analyzed inductively with thematic content analysis. Results: The interviews revealed a lack of information about disease, treatment and nursing care. The participants expressed fear and worries about their forthcoming surgery, anesthesia, pain, methods of pain management, possible complications and their prevention as well as their prognosis. Conclusions: The results show that the participants lacked information about treatment, nursing, anesthesia, rehabilitation, wound care or about post-surgery period. Instead they felt fear and anxiety. The participants were excluded from treatment and nursing processes. According to the participants, their information needs were different before and after the surgery. Lack of information prevents patients from acting self-dependently in their care.

A novel debridement device for the treatment of hard-to-heal wounds: a prospective trial

2021 ◽  
Vol 30 (Sup5) ◽  
pp. S32-S36
Author(s):  
Omar Al-Jalodi ◽  
Laura M Serena ◽  
Kristy Breisinger ◽  
Keyur Patel ◽  
Khristina Harrell ◽  
...  
Keyword(s):  
Fluorescence Imaging ◽  
Wound Care ◽  
Bacterial Load ◽  
Prospective Trial ◽  
Comfort Level ◽  
Care Practice ◽  
Prospective Clinical Study ◽  
Bacterial Burden ◽  
Before And After ◽  
Direct Pressure

Objective: Debridement, the removal of nonviable tissue, forms the foundation of wound care practice. Clinicians have a variety of debridement methods at their disposal: sharp, biologic, enzymatic, autolytic and mechanical. The choice of debridement technique depends on the patient care setting, ulcer type and the clinician's experience, training, comfort level and licensure. This prospective study evaluated a novel debridement instrument, EZ-Debride (MDM Ventures, US). Cutting flutes on the head of the tool permit uniform removal of dead tissue while lessening the risk of deeper injury. It may also minimise pain during the debridement procedure. Method: Subjects with hard-to-heal wounds, drawn from a single wound care centre, participated in this institutional review board-approved prospective clinical study. Pain was measured before, during and after debridement using a numerical scale. Assessment of bacterial burden using fluorescence imaging (MolecuLight, Canada) was performed before and after debridement. Results: Enrolment of 10 male and 12 female subjects, with a total of 28 wounds, was carried out over a two-month period by two investigators at a single institution. The average age of subjects was 64 years (range: 22–95 years). The average wound duration was 29 weeks (range: 6–142 weeks). Wound types included diabetic foot, venous leg and pressure ulcers, post-surgical and traumatic wounds. The average pain score at the time of enrolment was 3.9. Subjects reported an average increase in pain with debridement of 0.6 points (range: 0–8). Fluorescence imaging demonstrated a reduction in bacterial load in 69% of cases, with complete resolution in 19% of wounds. Haemostasis was achieved with direct pressure in all cases and the only adverse event was a wound infection that occurred four days after debridement. Conclusion: The results suggest that this novel debridement tool can safely remove nonviable tissue with minimal discomfort and reduce bacterial burden similar to results achieved by sharp debridement.

scholarly journals Nursing work in assisted human reproduction: between technology and humanization

2020 ◽  
Vol 73 (3) ◽  
Author(s):  
Ana Beatriz Azevedo Queiroz ◽  
Renata Porto dos Santos Mohamed ◽  
Maria Aparecida Vasconcelos Moura ◽  
Ivis Emília de Oliveira Souza ◽  
Maria Cristina de Melo Pessanha Carvalho ◽  
...  
Keyword(s):  
Nursing Care ◽  
Social Representations ◽  
Social Representation ◽  
Human Reproduction ◽  
Care Practice ◽  
Structured Interviews ◽  
Health Care Practice ◽  
Assisted Human Reproduction ◽  
Lack Of Information ◽  
The Social

ABSTRACT Objectives: To analyze the social representations of nurses who work with assisted human reproduction about the operation with reproductive biotechnologies. Methods: Qualitative approach, supported by the Theory of Social Representations, with sixteen participants. Individual, semi-structured interviews, analyzed through the Alceste software. Results: Pragmatic elements related to nurses’ performance from a professional, institutional, and public policy perspective in reproductive biotechnologies emerged, demonstrating the practical dimension of these representations. The characteristics of the professional to act in this area were addressed, showing the lack of information and search for scientificity; precarious perception of the organizational structure of health services; and attributions of nursing care arising from the health care practice in assisted human reproduction. Final considerations: Social representation is anchored in the link between technology/medicalization and humanization/reception regarding reproductive biotechnologies. Working in assisted human reproduction involves a new and challenging nursing care, requiring specific and ethical knowledge.

The Analysis of Nurses’ Positive Deviance Behaviours as a Measure in Preventing the Transmission of Healthcare-Associated Infections (HAIs) at M. Djamil Hospital, Padang, West Sumatera

2018 ◽  
Vol 1 (1) ◽  
pp. 3-7
Author(s):  
Esthika Ariany Maisa ◽  
Yulastri Arif ◽  
Wawan Wahyudi
Keyword(s):  
Grounded Theory ◽  
Wound Care ◽  
Positive Deviance ◽  
Care Practice ◽  
Theory Approach ◽  
Nursing Managers ◽  
Theoretical Sampling ◽  
Develop Theory ◽  
Healthcare Associated ◽  
Grounded Theory Approach

Purpose: To explore the nurses’ positive deviance behaviors as an effort to provide solutions in preventing and controlling infections in the hospital. Method: This is a qualitative research using grounded theory approach. Thirteen nurses from Dr.M.Djamil hospital were selected based on theoretical sampling in order to develop theory as it appears. Nurses were interviewed from June to September 2014. Interviews were thematically analyzed using techniques of grounded theory to then generate a theory from themes formed. Findings: The modes of positive deviance behavior identified were practicing hand hygiene beyond the standards (bringing handsanitizer from home), applying nursing art in wound care practice, placing patients with MRSA infections at the corner side, giving a red mark on a MRSA patient’s bed for easy identification by nurses, changing clothes and shoes in hospital, reducing hooks on the wall, and cleaning the ward on scheduled days. Conclusion: The study shows that nurses have a number of positive deviance behaviors to prevent infection transmission in the wards. It is sugested that the hospital management and nursing managers adopt some of the uncommon solution highlighted by the nurses to solve the HAIs problems in the hospital.

scholarly journals THU0642-HPR EVOLUTION OF THE PERCEPTIONS OF RA PATIENTS AFTER EDUCATION PATIENT SESSION TEACHING METHOTREXATE SELF-INJECTION A PROSPECTIVE PILOT STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 566.1-566
Author(s):  
S. Afilal ◽  
H. Rkain ◽  
B. Berchane ◽  
J. Moulay Berkchi ◽  
S. Fellous ◽  
...  
Keyword(s):  
Pilot Study ◽  
Patient Education ◽  
Median Duration ◽  
Large Scale ◽  
Education Session ◽  
Prospective Pilot Study ◽  
Mean Delay ◽  
Lack Of Information ◽  
Level Of Satisfaction ◽  
Before And After

Background:Methotrexate is a gold standard for treatment of RA. In our context, RA patients prefer to be injected by paramedics rather than self-injecting. This can be explained by patients’ bad perceptions of self-injection or lack of information. Appropriate self-injection education can therefore be an important element in overcoming these obstacles and improving disease self-management.Objectives:Compare the RA patients’ perceptions on methotrexate self-injection before and after a patient education session.Methods:Prospective pilot study that included 27 consecutive patients (81.5% female, mean age 44.4 years, illiteracy rate 40.7%) with RA (median duration of progression of 4 years, mean delay in referral for specialist of 6 months, median duration of methotrexate use of 1 year). The patients benefited from an individual patient education session to learn how to self-inject with methotrexate subcutaneously. The patient education session was supervised by a nurse and a rheumatologist with a control a week later. Perceptions of the reluctance to self-inject and the difficulties encountered by patients were assessed before the patient education session, after the 1st and 2nd self-injection of methotrexate using a 10 mm visual analog scale. Patients also reported their level of satisfaction (10 mm VAS) after the 1st and 2nd self-injection.Results:The mean duration of patient education session is 13 min.Table I compares the evolution of the degrees of reluctance to self-injection, the difficulties encountered, and the satisfaction experienced by the patients.Table 1.Evolution of RA patients’ perceptions on the methotrexate self-injection. (N = 27)BeforeAfter the 1stself-injectionAfter the 2end self-injectionpVAS reluctance (0-10mm)6,5 ± 3,62,2 ± 2,91,0 ± 2,3<0,0001VAS difficulty (0-10mm)7,5 ± 2,62,5 ± 2,71,0 ± 1,9<0,0001VAS satisfaction (0-10mm)-8,9 ± 1,89,5 ± 1,50,002Conclusion:This study suggests the effectiveness of a methotrexate self-injection patient education session in RA patients. It also highlights the value of patient education in rheumatologic care. A large-scale study is necessary to better interpret and complete these preliminary results from this pilot study.Disclosure of Interests:None declared

scholarly journals Selective Decontamination of the Digestive Tract to Prevent Postoperative Pneumonia and Anastomotic Leakage after Esophagectomy: A Retrospective Cohort Study

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 43
Author(s):  
Robin Janssen ◽  
Frans Van Workum ◽  
Nikolaj Baranov ◽  
Harmen Blok ◽  
Jaap ten Oever ◽  
...  
Keyword(s):  
Cohort Study ◽  
Anastomotic Leakage ◽  
Digestive Tract ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Protective Factor ◽  
Gastrointestinal Surgery ◽  
Surgical Site Infections ◽  
Selective Decontamination ◽  
Postoperative Pneumonia

Infectious complications occur frequently after esophagectomy. Selective decontamination of the digestive tract (SDD) has been shown to reduce postoperative infections and anastomotic leakage in gastrointestinal surgery, but robust evidence for esophageal surgery is lacking. The aim was to evaluate the association between SDD and pneumonia, surgical-site infections (SSIs), anastomotic leakage, and 1-year mortality after esophagectomy. A retrospective cohort study was conducted in patients undergoing Ivor Lewis esophagectomy in four Dutch hospitals between 2012 and 2018. Two hospitals used SDD perioperatively and two did not. SDD consisted of an oral paste and suspension (containing amphotericin B, colistin, and tobramycin). The primary outcomes were 30-day postoperative pneumonia and SSIs. Secondary outcomes were anastomotic leakage and 1-year mortality. Logistic regression analyses were performed to determine the association between SDD and the relevant outcomes (odds ratio (OR)). A total of 496 patients were included, of whom 179 received SDD perioperatively and the other 317 patients did not receive SDD. Patients who received SDD were less likely to develop postoperative pneumonia (20.1% vs. 36.9%, p < 0.001) and anastomotic leakage (10.6% vs. 19.9%, p = 0.008). Multivariate analysis showed that SDD is an independent protective factor for postoperative pneumonia (OR 0.40, 95% CI 0.23–0.67, p < 0.001) and anastomotic leakage (OR 0.46, 95% CI 0.26–0.84, p = 0.011). Use of perioperative SDD seems to be associated with a lower risk of pneumonia and anastomotic leakage after esophagectomy.

scholarly journals Joint Consultation Clinic by Infectious Diseases Specialists and Podiatry team (ID-POD) Compliments the Care of Diabetic Patients with Foot Infections by Reducing Cost and Decreasing Outpatient Clinic Visits

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S328-S328
Author(s):  
Pushpalatha Bangalore Lingegowda ◽  
Say-Tat Ooi ◽  
Jyoti Somani ◽  
Chelsea Law ◽  
Boon Kiak Yeo
Keyword(s):  
Infectious Diseases ◽  
Diabetic Foot ◽  
Wound Care ◽  
Cost Savings ◽  
Outpatient Setting ◽  
Multidisciplinary Teams ◽  
Diabetic Patients ◽  
Wound Debridement ◽  
Diabetic Foot Infections ◽  
Before And After

Abstract Background Management of diabetic foot infections (DFI) is challenging and involves multidisciplinary teams to improve outcomes (1). Appropriate wound care of patients with DFI plays an important role in successfully curing infections and promote wound healing. In Singapore, Infectious Diseases (ID) specialists help in the management of DFI by recommending appropriate antibiotics for infected wounds while wound debridement are managed by Podiatrists (POD). When patients are hospitalized multidisciplinary teams including Vascular Surgery review patients. In the outpatient setting patients have multiple appointments including ID and Endocrinology etc. The time spent and costs incurred by patients for traveling to multiple appointments is considerable. A joint ID-POD clinic was initiated to reduce the cost and inconvenience for patients. Methods A joint weekly clinic was initiated in October’16 and the data was analyzed upto May’17. Finance was involved in deriving costs. The service costs for consultations payable by patients before and after the initiation of the joint clinic were compared. Results First 6 months experience of initiating the joint ID-POD clinic is reported. 35 unique patients had a total of 88 visits. 1/third of the patients had more than 2 visits to the joint clinic. For each visit to the joint clinic the patient paid 25% less compared with having separate clinics. The hospital lowered the service cost for the new clinic by 11%. This was done by minimizing the time involvement of the ID physician. Conclusion Joint ID-POD clinic for managing diabetic patients with foot infections revealed several advantages. Hospital outpatient visits for each patient decreased by 50% for those requiring care of both ID and POD, without compromising care. With the consolidation of care each individual patient had a cost savings of 25% for the joint consultation. This joint clinic while making it convenient for patients has revealed significant cost savings to patients especially for those requiring multiple visits. We recommend hospitals with high prevalence of Diabetes and Diabetic foot infections to consider joint ID-POD clinics to reduce hassle and increase saving for patients. Disclosures All authors: No reported disclosures.

scholarly journals Effect of intraruminal infusion of potassium on the site of magnesium absorption within the digestive tract in sheep

1997 ◽  
Vol 129 (1) ◽  
pp. 99-105 ◽  
Author(s):  
D. E. DALLEY ◽  
P. ISHERWOOD ◽  
A. R. SYKES ◽  
A. B. ROBSON
Keyword(s):  
Digestive Tract ◽  
Solid Phase ◽  
Latin Square ◽  
Cerium Chloride ◽  
Faecal Excretion ◽  
Absorption Increase ◽  
High K ◽  
Before And After ◽  
Lincoln University ◽  
Female Sheep

Sixteen 2-year old female sheep were fitted with ruminal and duodenal cannulae at Johnstone Memorial Laboratory, Lincoln University during 1989–90. They were offered, at 2 hourly intervals, a pelleted concentrate diet (900 g/day) and chaffed lucerne hay (100 g/day). In a split-plot experiment they were infused, intraruminally and at four rates, with potassium (providing 16, 26, 36 or 46 g K/kg food DM/day) and magnesium (providing 1·3, 1·8, 2·3 or 3·1 g Mg/kg food DM/day) within a Latin square design and with the liquid and solid phase markers 51chromium EDTA and 141cerium chloride. Net absorption of Mg before and after the duodenum was estimated from dietary intake, duodenal flow and urinary and faecal excretion of Mg.Increasing K intake resulted in a decline in net absorption of Mg from the entire digestive tract, supporting data in the literature. Increasing K intake from 16 to 46 g/kg DM decreased urinary Mg excretion by between 0·14 and 0·30 g/day, the extent of which was independent of the level of Mg intake. At high K intake Mg absorption from the rumen was reduced, the amount absorbed ranging from 0·07 g Mg/day at intakes of 1·3 g Mg/day and 46 g K/kg DM/day to 0·66 g Mg/day at intakes of 3·1 g Mg/day and 16 g K/kg DM/day. However, at high K intake, and when Mg absorption from the rumen was reduced, net Mg absorption from sites distal to the rumen was increased to an extent which suggested compensatory absorption. Increase in K intake was associated with a consistent reduction in plasma Mg concentration which was independent of Mg intake. Increases in Mg intake resulted in increases in Mg absorption and plasma Mg concentration at all rates of K intake in direct proportion to rate of intake. The reduction in Mg absorption from the rumen at high K intake was associated with an increase (0·3 units) in pH of rumen digesta.

Reducing Hospital-acquired Pressure Injuries Among Pediatric Patients Receiving ECMO: A Retrospective Study Examining Quality Improvement Outcomes

2021 ◽  
Vol 67 (9) ◽  
pp. 14-24
Author(s):  
Jordan Jackson ◽  
Holly Kirkland-Kyhn ◽  
Laura Kenny ◽  
Alana Beres ◽  
Stephanie Mateev
Keyword(s):  
Quality Improvement ◽  
Pediatric Patients ◽  
Wound Care ◽  
Occipital Region ◽  
Provider Education ◽  
Before And After ◽  
Prevention Interventions ◽  
Improvement Interventions ◽  
Quality Improvement Interventions ◽  
Hospital Acquired

BACKGROUND: Pediatric patients immobilized for certain procedures, such as extracorporeal membrane oxygenation (ECMO), are at high risk for developing hospital-acquired pressure injuries (HAPIs). PURPOSE: To evaluate the rate of HAPI occurrence in ECMO patients before and after implementation of prevention interventions. METHODS: Patients younger than 18 years of age who were placed on ECMO from January 2012 through March 2020 were identified, and patient data, including the development of a stage 3, 4, or unstageable pressure injuries, were abstracted. From August 2018 through December 2018, HAPI prevention interventions were implemented, which included targeted HAPI prevention and ECMO provider education, fluidized positioner provider education, and the addition of 2 wound care interventions for ECMO patients. RESULTS: Of the 120 ECMO patients identified, 5 (4.2%) developed a HAPI. All patients developed HAPI in the occipital region, and 1 patient developed an additional HAPI on their back. The median age of patients with HAPI was 1 month (interquartile range [IQR], 0.3–6.8 months). The median duration from ECMO cannulation to identification of HAPI was 9.5 days (IQR, 4.8–32.3 days). The median total run time was 4.9 days (IQR, 2.5-7.6 days): 8.5 days for patients who did develop a HAPI and 4.8 days for those who did not develop a HAPI (P = .02). The overall HAPI rate dropped from 4.8% of ECMO patients before quality improvement interventions to 0% of ECMO patients after quality improvement interventions. CONCLUSIONS: The development of stage 3, 4, or unstageable HAPIs in pediatric ECMO patients was low (4.2%) over the period studied (January 2012 through March 2020). As of the time of this writing, no HAPIs occurred after implementation of provider education in 2018.

Measuring Change in Nurses’ Perceptions About Family Nursing Competency Following a 6-Day Educational Intervention

2018 ◽  
Vol 24 (4) ◽  
pp. 508-537 ◽  
Author(s):  
Susanne Broekema ◽  
Marie Louise A. Luttik ◽  
Gabriëlle E. Steggerda ◽  
Wolter Paans ◽  
Petrie F. Roodbol
Keyword(s):  
Educational Intervention ◽  
Nursing Care ◽  
Family Intervention ◽  
Assessment Model ◽  
Paired Samples ◽  
Family Nursing ◽  
Positive Attitudes ◽  
Before And After ◽  
Nurses Perceptions ◽  
Depth Interviews

This study describes nurses’ perspectives about their experience of being involved in a 6-day educational intervention which focused on the development of competency in family nursing practice with a particular emphasis on family nursing conversations. The foundational knowledge of the educational intervention was based on the Calgary Family Assessment Model (CFAM) and the Calgary Family Intervention Model (CFIM). A research design incorporating quantitative and qualitative measurement was used. Before and after the family nursing educational intervention, nurse participants ( n = 18) completed the Families’ Importance in Nursing Care–Nurses’ Attitudes (FINC-NA) instrument. The outcomes were analyzed using paired-samples t tests. FINC-NA scores increased by 6.94 points ( SD = 5.66, p < .001). To complement the quantitative findings, in-depth interviews were conducted with all of the participants. Participants reported increased awareness of the importance of families in nursing care. In addition to an increase in positive attitudes about families, participants perceived that their knowledge and skills regarding family nursing conversations were more comprehensive. A 6-day educational intervention with a focus on reflection appears useful in helping nurses to “think family” and encouraging perceptions of increased competence in family nursing conversations.

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