scholarly journals Impact of Computerized Provider Order Entry on Total Parenteral Nutrition in the Neonatal Intensive Care Unit

2016 ◽  
Vol 21 (4) ◽  
pp. 339-345 ◽  
Author(s):  
Kyle A. Franco ◽  
Keliana O'Mara
Keyword(s):  
Parenteral Nutrition ◽  
Neonatal Intensive Care ◽  
Intervention Group ◽  
Preterm Neonates ◽  
Control Group ◽  
Order Entry ◽  
Serum Electrolyte ◽  
Computerized Provider Order Entry ◽  
Electrolyte Disturbances ◽  
Before And After

OBJECTIVES: To determine if computerized provider order entry (CPOE) implementation impacts the time it takes for preterm neonates to reach their parenteral macronutrient goals. METHODS: Retrospective review of neonates <1750 g receiving parenteral nutrition (PN) before and after the implementation of CPOE. Primary outcome was the attainment of parenteral macronutrient goals. Secondary outcomes included time to attainment, the frequency of electrolyte abnormalities, and the incidence of required adjustments made to PN orders by verification pharmacists. RESULTS: Goal PN was achieved by 12/47 (25.5%) intervention vs. 2/44 (4.5%) control group infants (p < 0.05). This goal was attained in 10.8 ± 7.5 days in the intervention group and 10 ± 4.2 days in the control group (p = 0.90). Goal protein was reached by 74.5% of CPOE patients vs. 36.4% of controls, p < 0.05. Lipid goals were achieved by 98% vs. 100% (p = 0.33) of patients and were attained at an average of 1.5 ± 0.8 days vs. 2.0 ± 1.1 days (p < 0.05). Abnormal serum electrolyte values occurred more frequently in the control group (0.79 vs. 1.12/day PN). Adjustments by a verification pharmacist were required in 5.6% of CPOE compared with 30.4% of control group orders (p < 0.05). CONCLUSIONS: CPOE parenteral nutrition increased the proportion of preterm neonates attaining overall macronutrient goals. With CPOE, protein goals were reached by more patients and goal lipids were achieved faster. This system also decreased the number of pharmacist interventions during verification of PN orders and appeared to positively impact the incidence of serum electrolyte disturbances.

Missed Care in Neonatal Intensive Care Unit: Effect of Eletronic Reminders  

2020 ◽  
Author(s):  
Fereshteh Bahrami ◽  
Mansooreh Azizzadeh Forouzi ◽  
Monirsadat Nematollahi ◽  
Beatrice Kalisch J. ◽  
Behnaz Bagherian
Keyword(s):  
Nursing Care ◽  
Neonatal Intensive Care ◽  
Information Technologies ◽  
Low Cost ◽  
Intervention Group ◽  
Sampling Technique ◽  
Control Group ◽  
Before And After ◽  
Missed Care ◽  
Missed Nursing Care

Abstract Background: Missed nursing care is a newly defined concept and refers to any aspect of required patient care that is omitted or delayed. This study aimed to determine the effectiveness of electronic reminders on missed care in NICU.Methods: This is a two groups (before and after) quasi experimental study. A random sampling technique was employed to collect a sample of 70 nurses among two NICUs in an educational hospital in the south east of Iran. Miss care questionnaire was used to determine Missed care before, immediate, and one month after the intervention. The study intervention includes sending electronic reminders regarding nursing care of NICU hospitalized neonate. Data were analyzed using SPSS20 software, descriptive (frequency, percentage, mean, and standard deviation), and analytical statistics. The level of significance was considered as 0.05.Results: The results showed that the mean score of missed care was decreased after intervention in the intervention group (6.74±8.47) rather than the control group (18.57±14.59) (P=0.001). The highest and the lowest mean score of missed care before and after the intervention was in general care and oxygen therapy domains in both groups. The second time intervention was one month after did not show any significant differences in the two groups. But decreasing in missed care was shown in both groups.Conclusion: using information technologies like whatsApp is an easy, low cost and available method which could help nurses decrease missed nursing care.

scholarly journals Packed Cell Transfusion and Feeding Tolerance in Healthy Preterm Infants: A Randomized Clinical Tria

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Minoo Fallahi ◽  
Mohammad Kazemian ◽  
Saeed Hojat Kashani ◽  
Saleheh Tajalli ◽  
Naeeme Taslimi
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Intervention Group ◽  
Preterm Neonates ◽  
Control Group ◽  
Significant Difference ◽  
Packed Cell Transfusion ◽  
Feeding Tolerance

Background: Recently, the correlation between necrotizing enterocolitis (NEC) and packed cell transfusion (PCT) has been identified. Evidence shows that 25 - 35% of NEC cases are associated with PCT. Objectives: this study aimed to determine the association between PCT and feeding tolerance in healthy preterm newborns. Methods: Materials and Methods: This clinical trial was performed on preterm infants, admitted to the neonatal intensive care unit (NICU) of Mofid Children's Hospital, Tehran, Iran, from April 2017 to May 2018. A total of 70 healthy premature infants (birth weight < 1500 g and gestational age < 32 weeks) with enteral feeding, who required PCT, were included in this study. The eligible infants were divided into two groups by simple randomization. In the intervention group (n = 35), breastfeeding was withheld only during PCT and then continued as usual. On the other hand, in the control group (n = 35), feeding was performed as usual, regardless of PCT. Feeding tolerance within the first 72 hours post-transfusion was compared between the two groups. Sick newborns were excluded from the study. Data analysis was performed in SPSS version 20. Results: The mean gestational age, birth weight, and postnatal age of the neonates were 30.13 weeks, 1245.71 g, and 17 days in the intervention group and 29.97 weeks, 1169.43 g, and 15.46 days in the control group, respectively; there was no significant difference between the two groups. Except for pre-transfusion hemoglobin and hematocrit levels, other characteristics of the two groups were similar. Feeding tolerance was reported in 32 (91.2%), 33 (94.73%), and 34 (97.1%) newborns at 24, 48, and 72 hours post-transfusion in both groups, without any significant difference. There was no significant difference between neonates with and without feeding tolerance in either of the groups. Conclusions: According to the present results, withholding feeding during PCT is not necessary in healthy preterm neonates with a good general condition, and continued breastfeeding seems to be a safe option.

scholarly journals Benefit of a pharmacist-led intervention for medication management of renal transplant patients: a controlled before-and-after study

2021 ◽  
Vol 12 ◽  
pp. 204062232110052
Author(s):  
Jeremy Chambord ◽  
Lionel Couzi ◽  
Pierre Merville ◽  
Karine Moreau ◽  
Fabien Xuereb ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Immunosuppressive Therapy ◽  
Medication Management ◽  
Intervention Group ◽  
Knowledge Score ◽  
Control Group ◽  
Patient Knowledge ◽  
Transplant Patients ◽  
Before And After ◽  
High Level

Aims: To assess the effect of a pharmacist-led intervention, using Barrows cards method, during the first year after renal transplantation, on patient knowledge about their treatment, medication adherence and exposure to treatment in a French cohort. Methods: We conducted a before-and-after comparative study between two groups of patients: those who benefited from a complementary pharmacist-led intervention [intervention group (IG), n = 44] versus those who did not [control group (CG), n = 48]. The pharmacist-led intervention consisted of a behavioral and educational interview at the first visit (visit 1). The intervention was assessed 4 months later at the second visit (visit 2), using the following endpoints: treatment knowledge, medication adherence [proportion of days covered (PDC) by immunosuppressive therapy] and tacrolimus exposure. Results: At visit 2, IG patients achieved a significantly higher knowledge score than CG patients (83.3% versus 72.2%, p = 0.001). We did not find any differences in treatment exposure or medication adherence; however, the intervention tended to reduce the proportion of non-adherent patients with low knowledge scores. Using the PDC by immunosuppressive therapy, we identified 10 non-adherent patients (10.9%) at visit 1 and six at visit 2. Conclusions: Our intervention showed a positive effect on patient knowledge about their treatment. However, our results did not show any improvement in overall medication adherence, which was likely to be because of the initially high level of adherence in our study population. Nevertheless, the intervention appears to have improved adherence in non-adherent patients with low knowledge scores.

scholarly journals Toe Clearance Rehabilitative Slippers for Older Adults With Fall Risk: A Randomized Controlled Trial

2021 ◽  
Vol 12 ◽  
pp. 215145932110291
Author(s):  
Atsuko Satoh ◽  
Yukoh Kudoh ◽  
Sangun Lee ◽  
Masumi Saitoh ◽  
Miwa Miura ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Controlled Trial ◽  
Intervention Group ◽  
Berg Balance Scale ◽  
Control Group ◽  
Mobility Assessment ◽  
Before And After ◽  
Day Services ◽  
And Control

Introduction: To evaluate fall-prevention rehabilitative slippers for use by self-caring, independent older adults. Materials and Methods: This assessor-blinded, randomized, and controlled 1-year study included 59 self-caring, independent participants (49 women) who attended day services. The mean age of participants was 84.0 ± 5.3 years. Participants were randomly selected from 8 nursing homes. We tested slippers top-weighted with a lead bead (200, 300, or 400 g). Intervention group participants walked while wearing the slippers for 10-20 min, 1-3 days/week at the day service center. Fall risk was measured using the Berg Balance Scale and the Tinetti Performance-Oriented Mobility Assessment (POMA) before and at 3-month intervals after the intervention/control phase. Results: After 12 months, the intervention group demonstrated significant improvement. Berg Balance and POMA compared to the control group ( p < .05 p < .01, respectively). Mobility scores improved significantly for both measurements in the intervention group before and after ( p < .01), but the control group had significantly lower scores. Discussion: Overall, falls decreased in the intervention group from 10 to 7, and control group falls increased from 9 to 16 ( p = .02). No adverse events related to the intervention were reported. Conclusions: Rehabilitation training slippers may reduce falls in older adults.

The effectiveness of emotional freedom techniques (EFT) on depression of postmenopausal women: a randomized controlled trial

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Asieh Mehdipour ◽  
Parvin Abedi ◽  
Somayeh Ansari ◽  
Maryam Dastoorpoor
Keyword(s):  
Randomized Controlled Trial ◽  
Postmenopausal Women ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Moderate Depression ◽  
Before And After ◽  
The Mean ◽  
And Control

Abstract Objectives Postmenopausal women are at greater risk of depression. Depression may negatively affect the quality of life of women. An emotional freedom technique (EFT) is an evidence-based therapy combining cognitive and exposure components with acupressure. This study aimed to evaluate the effect of EFT on depression in postmenopausal women. Methods This was a randomized controlled trial in which 88 women with mild to moderate depression recruited from a menopausal clinic in Ahvaz, Iran, and randomly assigned into two groups of EFT (n=44) and control for sham therapy (n=44). Women in the EFT group received two sessions of training and asked to continue EFT for 8 weeks, one time per day. The Beck Depression Inventory (BDI2) completed by women before and after the intervention. The control group received training on sham acupressure points similar to the intervention group. Data collected using a demographic and BDI2. Women requested to complete the BDI2 before and after the intervention. The independent t-test, chi-square, and ANCOVA were used to analyze data. Results The mean depression score in the intervention group reduced from 20.93 ± 4.6 to 10.96 ± 4.38 in comparison to the control group that reduced from 19.18 ± 2.79 to 17.01 ± 6.05 after intervention (p=0.001). After the 8 week intervention, the frequency of moderate depression decreased from 56.8 to 9.35% in the intervention and from 50 to 29.5% in the control group. In total, 63.4 and 34.15% in the intervention and control groups were free of depression respectively after the intervention (p<0.001). Conclusions The results of this study showed that using EFT for 8 weeks could significantly reduce the mean score of depression in postmenopausal women. Using this method in public health centers for postmenopausal women is recommended.

Effects of an Off-Site Walking Program on Energy Expenditure, Serum Lipids, and Glucose Metabolism in Middle-Aged Women

2003 ◽  
Vol 4 (3) ◽  
pp. 181-192 ◽  
Author(s):  
Fumiko Furukawa ◽  
Keiko Kazuma ◽  
Masako Kawa ◽  
Mitsunori Miyashita ◽  
Kyohko Niiro ◽  
...  
Keyword(s):  
Energy Expenditure ◽  
Nurse Managers ◽  
Intervention Group ◽  
Density Lipoprotein ◽  
Control Group ◽  
Middle Aged ◽  
Walking Program ◽  
Before And After ◽  
The Mean ◽  
Blood Profiles

The present study aims to identify the effects of systematic walking on exercise energy expenditure (EEE) and blood profiles in middle-aged women. Fifty-two female nurse managers, aged 32 to 57 years (42.0 ± 6.2), were randomly assigned to an intervention group (IG) and a control group (CG) for a 12-week study of the walking program. EEE was measured using a microelectronic device. Blood profiles were assessed before and after the walking program. The mean EEE (kcal/kg/d) in the IG and CG was 4.73 ± 1.02 and 3.88 ± 0.81 ( P = 0.01), indicating an increase of 1.17 ± 0.98 and 0.46 ± 0.68 from baseline ( P = 0.01), respectively. The mean change in high-density lipoprotein cholesterol in the IG and CG was 1.8 ± 8.3 mg/dL and −2.9 ± 7.0 mg/dL ( P = 0.051); that in insulin was −4.5 ± 7.5 μU/dL and −0.6 ± 4.3 μU/dL ( P = 0.046), respectively. These results show that systematic walking increases EEE and improves blood profiles.

THE EFFECT OF DHIKR ON ANXIETY AND DEPRESSION LEVEL IN HEMODIALYSIS PATIENTS AT PURWOKERTO ISLAMIC HOSPITAL

2021 ◽  
Vol 2 (1) ◽  
pp. 15-25
Author(s):  
Muhammad Anggun ◽  
Titik Kusumawinakhyu ◽  
Irma Finurina Mustikawati ◽  
Wiharto Wiharto
Keyword(s):  
Intervention Group ◽  
Depression Scale ◽  
Sampling Technique ◽  
Hemodialysis Patients ◽  
Anxiety And Depression ◽  
Control Group ◽  
Control Group Design ◽  
Hemodialysis Unit ◽  
Before And After ◽  
The Mean

Hemodialysis is a routinely performed therapy on chronic kidney patients, leading to psychological problems among subjects who undergo hemodialysis, such as anxiety and depression. One of the efforts to overcome anxiety and depression is with the dhikr intervention. Dhikr presents hearts to remember and be obedient to Allah followed by the words and actions in various conditions.  Discover dhikr's influence on the level of anxiety and depression in patients on hemodialysis in  Purwokerto Islamic Hospital. It was a quantitative study using quasi experiment with a non-quivalent control group design. The number of samples was 12 subjects consisting of 6 subjects in the control group and six subjects in the intervention group with the purposive sampling technique. Instruments were used to measure anxiety and depression are the HADS ( Hospital Anxiety and Depression Scale ) before and after dhikr intervention as much as 12 times. Research is carried out in Hemodialysis Unit of  Purwokerto Islamic Hospital. Test statistics on research are used paired t-test and independent t-tests. This study showed a decrease in the mean level of anxiety from 5, 83 to 1.67 in the experimental group ( p = 0.003). The mean level of depression experienced a decline of 9, 67 becomes 4.67 on a group experiment ( p = 0.003). Dhikr reduces the level of anxiety and depression in hemodialysis patients at the Purwokerto Islamic Hospital.

scholarly journals A Sterile Collection Bundle Intervention Reduces the Recovery of Bacteria from Neonatal Blood Culture

2018 ◽  
Vol 3 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Linze F. Hamilton ◽  
Helen E. Gillett ◽  
Adam Smith-Collins ◽  
Jonathan W. Davis
Keyword(s):  
Intensive Care ◽  
Blood Culture ◽  
False Positive ◽  
Neonatal Intensive Care ◽  
Intervention Group ◽  
Group Versus ◽  
Antibiotic Use ◽  
Culture Collection ◽  
Blood Cultures ◽  
Before And After

Background: In neonatal intensive care, coagulase-negative Staphylococcus species can be both blood culture contaminants and pathogens. False-positive cultures can result in clinical uncertainty and unnecessary antibiotic use. Objective: This study sought to assess whether a sterile blood culture collection bundle would reduce the incidence of false-positive blood cultures in a regional neonatal intensive care unit. Method: Clinical data was collected from all infants who had blood cultures taken before and after the introduction of the sterile blood culture collection bundle intervention. This intervention required 2% chlorhexidine and full sterile precautions for blood culture collection. False-positive blood culture rates (presence of skin commensals and ≥3 clinical infection signs) were compared before and after the intervention. The number of days of unnecessary antibiotics associated with false-positive blood cultures was also analysed. Results: In the pre-intervention group (PRE) 197 cultures were taken from 161 babies. In the post-intervention group (POST) 170 cultures from 133 babies were acquired. Baseline demographics were similar in both groups. The rate of false-positive cultures in the PRE group versus the POST group was 9/197 (4.6%) compared to 1/170 (0.6%) (p < 0.05). Unnecessary antibiotic exposure was reduced in the PRE group in comparison to the POST group (27 vs. 0 days, p < 0.01). Conclusions: Implementation of sterile blood culture collection intervention reduced the number of false-positive results. This has potential benefit in reducing unnecessary antibiotic use.

scholarly journals Pengaruh Terapi Murrotal Terhadap Penurunan Tingkat Nyeri dan Kecemasan Saat Perawatan Luka Pasien Ulkus Dm Di Rsud K.R.M.T. Wongsonegoro Semarang

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Dyah Restuning Prihati ◽  
Maulidta Karunianingtyas Wirawati
Keyword(s):  
Wound Care ◽  
Stress Hormones ◽  
Sample Selection ◽  
Intervention Group ◽  
Wilcoxon Test ◽  
Control Group ◽  
Measuring Instruments ◽  
Diabetic Ulcer ◽  
Before And After ◽  
Quasi Experimental

Diabetic ulcer is caused by damage to the skin nerves due to reduced blood flow. Pain and anxiety when wound care begins when dressing and cleaning the wound. Murottal therapy is a distraction technique in the form of al-quran records, decreases stress hormones and provides a feeling of relaxation. The purpose of this study was to reduce the level of pain and anxiety during wound care in patients with DM ulcers after being given murrotal therapy in RSUD K.M.T. Wongsonegoro Semarang. The research method with quasi experimental pre-posttest control group. a sample of 17 people in the intervention group and 15 in the control group. Sample selection with total sampling. The murrottal listening intervention group played for 3 times for 15 minutes. Respondents were conducted pre and posttest with NRS pain measuring instruments and DASS anxiety. The results of the Wilcoxon test in the intervention group obtained p = 0,000, there were differences in the level of pain between before and after murotal therapy and p = 0.002 there was a difference in the level of anxiety between before and after murotal therapy. In the control group obtained p = 0.02, there were differences in the level of pain between before and after murotal therapy and the value of p = 1.00, there was no difference in the level of anxiety between before and after given murotal therapy. Conclusion: Murrotal therapy can reduce the level of pain and anxiety during wound care for DM ulcer patients.

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