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Pyloric Channel Stricture Secondary To High-Dose Ibuprofen Therapy In A Patient With Cystic Fibrosis, E. Bell, R. Grothe, V. Zivkovich, Jan Foote, J. Wellendorf Dec 2011

Pyloric Channel Stricture Secondary To High-Dose Ibuprofen Therapy In A Patient With Cystic Fibrosis, E. Bell, R. Grothe, V. Zivkovich, Jan Foote, J. Wellendorf

Jan M. Foote

OBJECTIVE: To describe a case of pyloric channel stricture secondary to high-dose ibuprofen therapy in a pediatric patient with cystic fibrosis. CASE SUMMARY: A 12-year-old white girl started taking high-dose ibuprofen to treat the pulmonary manifestations of cystic fibrosis. The peak plasma concentration at dose initiation was within the accepted therapeutic range. Approximately one month later, the patient developed emesis and intolerance of solid foods, which persisted for several months and resulted in a weight loss of seven kilograms. The patient was referred to a pediatric gastroenterologist, who performed an upper endoscopy and subsequently diagnosed a pyloric channel stricture. The …


Informational Needs Of Caregivers Of Terminal Patients In A Rural State, Virginia Conley, M. Burman Nov 2011

Informational Needs Of Caregivers Of Terminal Patients In A Rural State, Virginia Conley, M. Burman

Virginia M. Conley

Home care of a terminally ill family member is stressful, especially in rural areas. This qualitative study sought to determine informational needs of rural caregivers and how that information is obtained. Although most caregivers stated satisfaction with available information, mostly obtained from physicians and nurses, their behavior belied their satisfaction. Assertive and self-reliant, they used informal communications rather than written information to meet most of their needs. Approaches home care nurses can use to help caregivers obtain important information are presented.


Never Did I Know: Iowa Nurses Association Resolution 2010 #2, Virginia Conley Nov 2011

Never Did I Know: Iowa Nurses Association Resolution 2010 #2, Virginia Conley

Virginia M. Conley

No abstract provided.


Conflict And Retention Of New Graduate Nurses, Diane Gardner Nov 2011

Conflict And Retention Of New Graduate Nurses, Diane Gardner

Diane Huber

No abstract provided.


Career Commitment In Nursing, Diane Gardner Nov 2011

Career Commitment In Nursing, Diane Gardner

Diane Huber

There are different patterns and styles to careers in nursing. The concept of career commitment in nursing is explored, and the results of some research are discussed for their implications for nursing careers. A longitudinal, repeated-measures descriptive survey was used to measure career commitment and explore its relationship to turnover and work performance in 320 newly employed registered nurses at one hospital. Career commitment scores dropped significantly over the first year. Although career commitment does correlate with turnover, and there is a relationship with job performance, the direct association is weak. Career commitment is not a stable phenomenon in the …


Fatigue In Postpartum Women, Diane Gardner Nov 2011

Fatigue In Postpartum Women, Diane Gardner

Diane Huber

Childbirth and the responsibilities of parenting after birth require a great deal of energy. Fatigue in postpartum women is a concern for maternal-child nurses because of the impact on the health and parenting ability of the mother. To determine fatigue levels and types, 35 women who vaginally delivered were surveyed at 2 days, 2 weeks, and 6 weeks postpartum. This sample was found to be mildly fatigued, with situational and/or psychological fatigue. Nurses can intervene by assessing postpartum fatigue and using teaching/counseling methods for knowledge preparation and for clients at risk.


Patient Preferences And Discharge Planning Transitions, Diane Huber, E. Mcclelland Nov 2011

Patient Preferences And Discharge Planning Transitions, Diane Huber, E. Mcclelland

Diane Huber

Discharge planning is an urgently needed nursing intervention. The purpose of this article is to investigate the importance of patient and family preferences and participation for discharge planning and to describe the pilot testing of an instrument to measure patient preferences for discharge planning. The results identified a lack of congruence between patients' and caregivers' preferences, suggesting the need to assess both patients' and families' preferences early and incorporate this in discharge planning that begins at admission to a hospital. The instrument, Patient Participation Preferences Assessment (PPPA), is shown to be a useful, reliable, and valid instrument that can be …


Psychometric Evaluation Of The Structured Clinical Interview For Dsm-Iv Childhood Diagnoses (Kid-Scid), D. Smith, Diane Huber, J. Hall Nov 2011

Psychometric Evaluation Of The Structured Clinical Interview For Dsm-Iv Childhood Diagnoses (Kid-Scid), D. Smith, Diane Huber, J. Hall

Diane Huber

The purpose of this study was to evaluate the reliability and validity of selected modules of the Structured Clinical Interview for DSM IV (KID-SCID, Version 1.0). The Disruptive Behavior Disorders (i.e., ADHD, ODD, CD) and Substance Related Disorders modules of the KID-SCID were administered to 50 adolescents receiving residential treatment for substance abuse and severe behavioral problems. This study examined available evidence for inter-rater reliability and convergent validity. Convergent validity was demonstrated for the Disruptive Behavior Disorders module, however, the Substance Abuse Disorders module failed to converge with frequency of use for most substances. Inter-rater reliability was generally high. This …


Excellence In Nursing: An Adolescent Parenting Program, Diane Gardner Nov 2011

Excellence In Nursing: An Adolescent Parenting Program, Diane Gardner

Diane Huber

No abstract provided.


Evaluating The Impact Of Case Management Dosage, Diane Huber, M. Sarrazin, T. Vaughn, J. Hall Nov 2011

Evaluating The Impact Of Case Management Dosage, Diane Huber, M. Sarrazin, T. Vaughn, J. Hall

Diane Huber

BACKGROUND: Because of the broad range of activities involved and high variance in clients' needs, it is challenging to measure the actual dose of case management in order to assess quality and manage outcomes. OBJECTIVE: The purpose of this research is to evaluate the impact of intervention dosage on client outcomes in different case management models within substance abuse treatment. METHOD: A descriptive and repeated measures analysis from a clinical trials data set measured the dosage of case management and evaluated impact on client outcomes. A sample of 598 clients from a substance abuse treatment facility was randomized into one …


Telephone Nursing Interventions In Ambulatory Care, Diane Huber, K. Blanchfield Nov 2011

Telephone Nursing Interventions In Ambulatory Care, Diane Huber, K. Blanchfield

Diane Huber

Telephone nursing practice is becoming a major nursing activity in ambulatory care settings, yet little is known about the type and extent of nursing interventions that occur during telephone interactions. A pilot study was conducted in two sites to see whether nursing diagnoses and interventions could be captured and related to nursing care during telephone consultation. This initial pilot demonstrated that nurses have an appropriate role in telephone interactions and that standardized nursing language can be used in telephone nursing to document nursing care despite the many challenges in its use in the field.


Client Satisfaction With Rural Substance Abuse Case Management Services, T. Kopelman, Diane Huber, B. Kopelman, M. Sarrazin, J. Hall Nov 2011

Client Satisfaction With Rural Substance Abuse Case Management Services, T. Kopelman, Diane Huber, B. Kopelman, M. Sarrazin, J. Hall

Diane Huber

Although many substance abuse organizations offer case management services, little is known about clients' satisfaction as consumers of case management services. The purpose of this study was to evaluate consumer preferences regarding the delivery of case management services in a rural substance abuse treatment program. For this study, 120 clients (30 in each of four research conditions) were interviewed about their experiences in the Iowa Case Management Project (ICMP), a field-based clinical trial evaluating a strengths-based model of case management for rural clients in drug abuse treatment. A mixed-method approach evaluated clients' responses from a semistructured interview. Most clients preferred …


Catastrophic Reactions And Other Behaviors Of Alzheimer's Residents: Special Unit Compared With Traditional Units, Elizabeth Swanson, Meridean Maas, Kathleen Buckwalter Nov 2011

Catastrophic Reactions And Other Behaviors Of Alzheimer's Residents: Special Unit Compared With Traditional Units, Elizabeth Swanson, Meridean Maas, Kathleen Buckwalter

Elizabeth A. Swanson

Using a quasi-experimental pretest/posttest design, the effects of a Special Care Unit (SCU) on the incidence of catastrophic reactions and other behaviors of nursing home residents with Alzheimer's disease (AD) were examined. Findings indicate significantly fewer catastrophic reactions and other selected behavior changes occurred during the posttest period for subjects in the experimental group compared with the subjects in the control group. Implications for psychiatric consultation/liaison nurses (PCLNs) working with this vulnerable population are discussed.


Outcomes Of Family Involvement In Care Intervention For Caregivers Of Individuals With Dementia, Meridean Maas, D. Reed, M. Park, Janet Specht, D. Schutte, Lisa Skemp Kelley, Elizabeth Swanson, Toni Tripp-Reimer, Kathleen Buckwalter Nov 2011

Outcomes Of Family Involvement In Care Intervention For Caregivers Of Individuals With Dementia, Meridean Maas, D. Reed, M. Park, Janet Specht, D. Schutte, Lisa Skemp Kelley, Elizabeth Swanson, Toni Tripp-Reimer, Kathleen Buckwalter

Elizabeth A. Swanson

BACKGROUND: Despite the increasing number of individuals with dementia relocated from caregiving at home to a nursing home, there is only a small body of literature examining the influence of institutional family-oriented practices on family member perceptions of care and family-staff relationships. OBJECTIVE: The study tested the effects of the Family Involvement in Care partnership intervention on family members' perceptions of their caregiving role, relationships with staff, and satisfaction with the care of relatives with dementia residing in special care units as well as the effects on staff attitudes toward families and staff satisfaction with a caregiving role. METHODS: A …


Alzheimer's Residents' Cognitive And Functional Measures: Special And Traditional Care Unit Comparison, Elizabeth Swanson, Meridean Maas, Kathleen Buckwalter Nov 2011

Alzheimer's Residents' Cognitive And Functional Measures: Special And Traditional Care Unit Comparison, Elizabeth Swanson, Meridean Maas, Kathleen Buckwalter

Elizabeth A. Swanson

The aim of this field experiment was to compare the effects of a special care unit (SCU) on residents with Alzheimer's disease (AD) who lived on the SCU and on traditional (integrated) nursing home units. Twenty-two subjects, 13 on the SCU and 9 on traditional integrated units were compared. Repeated measures ANOVA was used to assess differences between the two groups and within the groups over two bimonthly pretests and two bimonthly posttests. No significant differences on cognitive or functional abilities scores were evident for the groups and no significant differences were found over time. However, consistent with the prediction …


Family Visitation On Special Care Units, Lisa Skemp Kelley, Elizabeth Swanson, Meridean Maas, Toni Tripp-Reimer Nov 2011

Family Visitation On Special Care Units, Lisa Skemp Kelley, Elizabeth Swanson, Meridean Maas, Toni Tripp-Reimer

Elizabeth A. Swanson

With placement of a family member with Alzheimer's disease on a SCU, the family does not relinquish the caregiving role, rather they take on different roles in relation to the residents. Family visitation of the residents on the SCU is an integral part of family involvement in care of individuals with Alzheimer's disease, as well as SCU functioning. Within the context of changing relationships with the residents, family members visited the residents as a sense of duty to "be faithful," to monitor care by "being their eyes and ears," and to foster a sense of family through ongoing relationships and …


Most Frequent Nursing Diagnoses, Nursing Interventions, And Nursing-Sensitive Patient Outcomes Of Hospitalized Older Adults With Heart Failure: Part 1, C. Scherb, B. Head, Meridean Maas, Elizabeth Swanson, Sue Moorhead, D. Reed, D. Conley, M. Kozel Nov 2011

Most Frequent Nursing Diagnoses, Nursing Interventions, And Nursing-Sensitive Patient Outcomes Of Hospitalized Older Adults With Heart Failure: Part 1, C. Scherb, B. Head, Meridean Maas, Elizabeth Swanson, Sue Moorhead, D. Reed, D. Conley, M. Kozel

Elizabeth A. Swanson

PURPOSE: Rank and compare the 10 most frequently documented nursing diagnoses, interventions, and patient outcomes using NANDA International, Nursing Interventions Classification, and Nursing Outcomes Classification for care of patients with heart failure (HF). METHODS: A descriptive comparative multisite study of documented care for 302 older adults with HF. FINDINGS: There were four common nursing diagnoses, two interventions, and only three common outcomes across three sites. CONCLUSIONS: This and similar analyses of clinical nursing data can be used by nursing administrators and clinicians to monitor the quality and effectiveness of nursing care. IMPLICATIONS: Similar analyses may be used for continuing education, …


Russian Citizens' Trusted Sources Of Health Promotion Information, C. Goody, Elizabeth Swanson, A. Bossen, E. Frolova, O. Kuznetsova, S. Plavinski Nov 2011

Russian Citizens' Trusted Sources Of Health Promotion Information, C. Goody, Elizabeth Swanson, A. Bossen, E. Frolova, O. Kuznetsova, S. Plavinski

Elizabeth A. Swanson

This study examined Russian citizens' trusted sources of health information. A random sample of 906 people, from two villages in St. Petersburg, Russia, responded to a health needs assessment questionnaire. Results suggest that medical professionals and special books, such as informational pamphlets about treating a myriad of illnesses, are significant trusted sources of health information for people in Russia. Further, these data suggest differences between trusted sources of health information exist between villages rather than by gender or age group. This work has implications for health care practitioners in Russia, who are advancing the discipline of family practice, as well …


Medication Management By Recently Hospitalized Older Adults, V. Conn, S. Taylor, Anita Stineman Nov 2011

Medication Management By Recently Hospitalized Older Adults, V. Conn, S. Taylor, Anita Stineman

Anita Stineman

Community-dwelling older adults often manage numerous prescriptive medications. The purpose of this study was to describe prescriptive medication management by older adults recently discharged from hospitals. The sample (N = 179) included adults, 65 to 101 years old, who managed a total of 950 prescriptive medications. Overall, subjects reported high confidence in their ability to manage medications. The lowest confidence levels were reported for recognizing unwanted side effects of medications. Although "forgetting" was the most commonly given reason for missed doses, one fourth of the reasons for missed doses indicated deliberate omission. Almost half of the subjects received assistance from …


Sensitivity Of Detection Of Radiofrequency Surgical Sponges: A Prospective, Cross-Over Study, Victoria Steelman Nov 2011

Sensitivity Of Detection Of Radiofrequency Surgical Sponges: A Prospective, Cross-Over Study, Victoria Steelman

Victoria J. Steelman

BACKGROUND: A retained surgical sponge is a serious medical error that results in negative patient outcomes. Radiofrequency (RF) technology has recently been introduced to evaluate for the presence of a retained sponge. The aim of this study was to evaluate the sensitivity and specificity of the detection of surgical sponges embedded with an RF chip through the torsos of subjects of varying body habitus, including the morbidly obese. METHODS: A prospective, crossover, and observer blinded study design was used. Subjects served as their own controls. With the subject supine, 4 surgical sponges were sequentially placed behind the subject's torso in …


Clinical Significance Of Positive Cranial Bone Flap Cultures And Associated Risk Of Surgical Site Infection After Craniotomies Or Craniectomies, H. Chiang, Victoria Steelman, J. Pottinger, A. Schlueter, D. Diekema, J. Greenlee, M. Howard, L. Herwaldt Nov 2011

Clinical Significance Of Positive Cranial Bone Flap Cultures And Associated Risk Of Surgical Site Infection After Craniotomies Or Craniectomies, H. Chiang, Victoria Steelman, J. Pottinger, A. Schlueter, D. Diekema, J. Greenlee, M. Howard, L. Herwaldt

Victoria J. Steelman

OBJECT: The risk of surgical site infection (SSI) after craniotomies or craniectomies in patients in whom contaminated bone flaps have been reimplanted has not been determined. The objectives of this study were to identify the prevalence of bone flaps with positive cultures--especially those contaminated with Propionibacterium acnes--to assess the risk of SSI after reimplanting (either during the initial operation or subsequently) bone flaps with positive cultures, and to identify risk factors for SSI following the initial craniotomies or craniectomies. METHODS: The authors conducted a retrospective review of cases in which patients underwent craniotomy/craniectomy procedures between January and October 2007 in …


Case Report Of Latex Aerosolization From A Transesophageal Echocardiogram Machine, B. Muller, Victoria Steelman Nov 2011

Case Report Of Latex Aerosolization From A Transesophageal Echocardiogram Machine, B. Muller, Victoria Steelman

Victoria J. Steelman

Aerosolized natural rubber latex proteins produce latex sensitization and can cause acute allergic reactions in susceptible individuals. The objective of this study is to describe measures that should be taken to ensure a latex-safe hospital environment. A case of latex-induced anaphylaxis prompted a survey of air quality in acute care areas of a major tertiary health care center that had eliminated the use of powder-free latex gloves years earlier. Six air samples were collected using pre- and postcalibrated sampling pumps operating at 2.7 L/minute. Samples were collected in duplicate on three-piece 37-mm Teflon filters in open-faced cassettes and tested for …


Creutzfeld-Jakob Disease: Recommendations For Infection Control, Victoria Steelman Nov 2011

Creutzfeld-Jakob Disease: Recommendations For Infection Control, Victoria Steelman

Victoria J. Steelman

Creutzfeld-Jakob disease, an infectious, progressive, degenerative neurologic disorder, has a presumably long incubation period but a rapid, fatal course. Brain tissue at autopsy resembles that seen in spongioform encephalopathies of other species. Creutzfeld-Jakob disease is transmitted by a proteinaceous infectious agent, or "prion." Epidemiologic patterns remain uncertain; various studies have reported conflicting risk factors in different populations, and genetic susceptibility may be involved. Although natural transmission routes are still unclear, both iatrogenic and nosocomial transmissions have been identified. Transmission has occurred through contaminated electrodes, contaminated biologic products from cadaveric brains, and infected donor tissues, including dura mater and corneas. Because …


Early- And Late-Onset Group B Streptococcal Infections: Overview And Case Studies, Rebecca Siewert, D. Holida Nov 2011

Early- And Late-Onset Group B Streptococcal Infections: Overview And Case Studies, Rebecca Siewert, D. Holida

Rebecca Siewert

Infants that are admitted and cared for in the neonatal intensive care unit are at risk for sepsis. Group B Streptococcus (GBS) is the most common cause of neonatal sepsis and meningitis. Group B Streptococcus is classified into early- and late-onset sepsis. With early onset, infants develop symptoms within 7 days of birth. With late onset, they develop symptoms between 7 days and 3 months of life. Prompt identification and treatment of suspected septic infants are crucial. Infants who develop early- or late-onset GBS sepsis are at risk for sequelae ranging from normal physiologic outcome to devastating long-term conditions and …


Breastfeeding Success With Preterm Quadruplets, L. Mead, Rebecca Chuffo, P. Lawlor-Klean, P. Meier Nov 2011

Breastfeeding Success With Preterm Quadruplets, L. Mead, Rebecca Chuffo, P. Lawlor-Klean, P. Meier

Rebecca Siewert

Although the incidence of triplet and quadruplet birth has increased in the United States, few research-based guidelines are available for assisting mothers of these multiple births with breastfeeding. The purpose of this case study is to report a successful breastfeeding experience of a mother with preterm quadruplets. The quadruplets were born by cesarean delivery at 34 weeks' gestation and weighed from 1,820 g to 2,240 g. In-hospital breastfeeding experiences were managed by the authors, according to research-based guidelines for breastfeeding preterm neonates and infants. During the first month after discharge of the four newborns, the mother breastfed 12-34 times daily. …


Screening And Counseling For Postpartum Depression By Nurses: The Women's Views, Lisa Segre, M. O'Hara, S. Arndt, C. Beck Nov 2011

Screening And Counseling For Postpartum Depression By Nurses: The Women's Views, Lisa Segre, M. O'Hara, S. Arndt, C. Beck

Lisa S. Segre

PURPOSE: In this part 2 article of research examining a model of care in which nurses screen and counsel postpartum women for postpartum depression, acceptability of such a model to postpartum patients was evaluated with a diverse sample of American women. STUDY DESIGN AND METHODS: Descriptive survey of two groups: 691 predominately white postpartum women with relatively high annual incomes (Sample 1) and 132 low-income women, some of whom were ethnic minorities (Sample 2). The surveys were distributed and needed to be mailed back to the investigators. The response rate was 72% in Sample 1 and 30% in Sample 2. …


Nursing Care For Postpartum Depression, Part 1: Do Nurses Think They Should Offer Both Screening And Counseling?, Lisa Segre, M. O'Hara, S. Arndt, C. Beck Nov 2011

Nursing Care For Postpartum Depression, Part 1: Do Nurses Think They Should Offer Both Screening And Counseling?, Lisa Segre, M. O'Hara, S. Arndt, C. Beck

Lisa S. Segre

PURPOSE: To assess nurses' views of a nursing model in which nurses screen and also treat new mothers who exhibit symptoms of depression. STUDY DESIGN AND METHODS: This is Part 1 of this descriptive survey (Part 2 in MCN 35(5)), in which nurses (n = 520) completed a statewide survey assessing nurses' views of a model of nursing care that both screens and treats postpartum depression. RESULTS: The majority "strongly agreed" or "agreed" with the statement "having nurses screen for depression using a brief screening tool is a good idea." Most (67.1%) chose the Ob-Gyn Clinic as the appropriate site …


The Prevalence Of Postpartum Depression: The Relative Significance Of Three Social Status Indices, Lisa Segre, Michael O'Hara, Stephan Arndt, Scott Stuart Nov 2011

The Prevalence Of Postpartum Depression: The Relative Significance Of Three Social Status Indices, Lisa Segre, Michael O'Hara, Stephan Arndt, Scott Stuart

Lisa S. Segre

BACKGROUND: Little is known about the prevalence of clinically significant postpartum depression in women of varying social status. The purpose of the present study was to examine the prevalence of postpartum depression as a function of three indices of social status: income, education and occupational prestige. METHOD: A sample of 4,332 postpartum women completed a demographic interview and the Inventory to Diagnose Depression, a self-report scale developed to identify a major depressive episode in accordance with DSM diagnostic criteria. Logistic regression was used to assess the relative significance of the three social status variables as risk factors for postpartum depression …


Interpersonal Psychotherapy For Antenatal And Postpartum Depression, Lisa Segre, Scott Stuart, Michael O'Hara Nov 2011

Interpersonal Psychotherapy For Antenatal And Postpartum Depression, Lisa Segre, Scott Stuart, Michael O'Hara

Lisa S. Segre

Despite its prevalence, postpartum depression is frequently not detected. Primary care physicians (PCPs) are often a woman's only contact with healthcare professionals. These professionals have a vital role in the screening and treatment of depressed women; therefore it is necessary that PCPs be aware of assessment issues and effective treatments. This article describes the use of interpersonal psychotherapy (IPT), a time-limited and empirically validated treatment for perinatal depression, in terms of the relevant clinical issues for pregnant or postpartum women. During the assessment phase, the symptoms of depression must be disentangled from the normal physical states of pregnancy and the …


Listening Visits: An Evaluation Of The Effectiveness And Acceptability Of A Home-Based Depression Treatment, Lisa Segre, S. Stasik, M. O'Hara, S. Arndt Nov 2011

Listening Visits: An Evaluation Of The Effectiveness And Acceptability Of A Home-Based Depression Treatment, Lisa Segre, S. Stasik, M. O'Hara, S. Arndt

Lisa S. Segre

Maternal depression affects approximately one in five women, is undertreated, and compromises infant development. In the United Kingdom, public health nurses provide an empirically supported intervention (Listening Visits [LV]) to depressed postpartum women. This study evaluates the effectiveness of LV when delivered by U.S. home visitors. Nineteen women with depressive symptoms received LV. Pre-, post-, and follow-up assessments evaluated depression status, life satisfaction, and treatment acceptability. Listening Visits were associated with a statistically and clinically significant reduction in depression, improvement in life satisfaction, and were acceptable to this sample of postpartum women. The LV intervention shows considerable promise as an …