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Full-Text Articles in Medicine and Health Sciences
Effectiveness Of Transcutaneous Electrical Nerve Stimulation On Postoperative Pain With Movement, Barbara Rakel, Rita Frantz
Effectiveness Of Transcutaneous Electrical Nerve Stimulation On Postoperative Pain With Movement, Barbara Rakel, Rita Frantz
Barbara A. Rakel
This study tested the effectiveness of episodic transcutaneous electrical nerve stimulation (TENS) as a supplement to pharmacologic analgesia on pain with movement and at rest after abdominal surgery and evaluated whether its use during walking and vital capacity maneuvers enhances performance of these activities. TENS, with a modulated frequency, intensity as high as the subject could tolerate, and electrodes placed on either side and parallel to the incision, was compared to placebo TENS and pharmacologic analgesia alone (control) by using a crossover design. Self-report of pain intensity, walking function, and vital capacity were assessed on 33 subjects. TENS resulted in …
Committee Meetings: An Electronic Alternative, Barbara Rakel
Committee Meetings: An Electronic Alternative, Barbara Rakel
Barbara A. Rakel
All too often, meetings are called without much thought as to whether or not they are necessary, wasting the staff's time and the organization's money. Sharing information and gathering input through electronic mail eliminates unproductive meetings and increases member productivity.
Nonpharmacologic Treatment Of Pain, M. Titler, B. Rakel
Nonpharmacologic Treatment Of Pain, M. Titler, B. Rakel
Barbara A. Rakel
Nonpharmacologic interventions for pain treatment are important complementary therapies but are not substitutes for pharmacologic management of pain. Use of nonpharmacologic pain treatments in critical care settings is helpful to decrease pain, but the challenge remains for nurses to have the knowledge, time, and skill to use these interventions in a busy daily practice with severely ill patients. Although numerous studies testing the effectiveness of nonpharmacologic interventions for pain management are available, the varying methods and interventions used in these studies make it difficult to draw conclusions. Further research on the use of these interventions for pain reduction is necessary …
A New Transient Sham Tens Device Allows For Investigator Blinding While Delivering A True Placebo Treatment, Barbara Rakel, N. Cooper, H. Adams, B. Messer, L. Frey Law, D. Dannen, C. Miller, A. Polehna, R. Ruggle, C. Vance, D. Walsh, K. Sluka
A New Transient Sham Tens Device Allows For Investigator Blinding While Delivering A True Placebo Treatment, Barbara Rakel, N. Cooper, H. Adams, B. Messer, L. Frey Law, D. Dannen, C. Miller, A. Polehna, R. Ruggle, C. Vance, D. Walsh, K. Sluka
Barbara A. Rakel
This study compared a new transient sham transcutaneous electrical nerve stimulation (TENS) that delivers current for 45 seconds to an inactive sham and active TENS to determine the degree of blinding and influence on pain reduction. Pressure-pain thresholds (PPT), heat-pain thresholds (HPT), and pain intensities to tonic heat and pressure were measured in 69 healthy adults before and after randomization. Allocation investigators and subjects were asked to identify the treatment administered. The transient sham blinded investigators 100% of the time and 40% of subjects compared to the inactive sham that blinded investigators 0% of the time and 21% of subjects. …
Interventions Related To Patient Teaching, Barbara Rakel
Interventions Related To Patient Teaching, Barbara Rakel
Barbara A. Rakel
This study validated 13 nursing interventions related to patient teaching. Four of the labels address the process of patient teaching, whereas the other nine concern content specific to teaching efforts. With the help of 46 master's-prepared nurses from across the country, critical (major) and supporting (minor) activities for each label were identified. This study is one of many steps toward the construction of a taxonomy of nursing interventions focused on direct care treatments that nurses perform on behalf of patients. The ultimate goal is to provide nurses with a standardized language that can be used to document their unique role …
From Book To Bedside: Putting Evidence To Use In The Care Of The Elderly, M. Titler, J. Mentes, Barbara Rakel, L. Abbott, S. Baumler
From Book To Bedside: Putting Evidence To Use In The Care Of The Elderly, M. Titler, J. Mentes, Barbara Rakel, L. Abbott, S. Baumler
Barbara A. Rakel
BACKGROUND: Infusion of research findings into clinical practice is a challenging part of the research process. Because the length of time between discovery and use of knowledge averages 20 years, methods are needed to speed translation of research findings into practice. Few efforts have been made to coordinate the generation of new knowledge with the dissemination of findings from research to improve care of the elderly. RESEARCH-BASED PRACTICE PROTOCOLS: The Research Development and Dissemination Core (RDDC) of the Gerontological Nursing Interventions Research Center (GNIRC) at the University of Iowa emphasizes development of research-based (RB) protocols, which requires collecting relevant literature, …
Clinical Outcome Of Emergency Repeat Coronary Artery Bypass Surgery, J. Lemmer, D. Ferguson, Barbara Rakel, N. Rossi
Clinical Outcome Of Emergency Repeat Coronary Artery Bypass Surgery, J. Lemmer, D. Ferguson, Barbara Rakel, N. Rossi
Barbara A. Rakel
To determine the clinical outcome of patients requiring emergency repeat coronary artery bypass graft (CABG) procedures, we reviewed 23 such procedures performed for ongoing myocardial ischemia refractory to medical management. The operative mortality was 17%. On follow-up, an average of 24.9 months after emergency reoperation, 14 of the 19 survivors (74%) had recurrent angina. As compared to a randomly selected group of 25 patients who underwent elective repeat CABG procedures during the same time period, the incidence of late cardiac events was significantly higher (79% in the emergency group, 30% in the elective surgery group) and fewer patients had received …
Physical Modalities In Chronic Pain Management, Barbara Rakel, J. Barr
Physical Modalities In Chronic Pain Management, Barbara Rakel, J. Barr
Barbara A. Rakel
The following conclusions can be made based on review of the evidence: There is limited but positive evidence that select physical modalities are effective in managing chronic pain associated with specific conditions experienced by adults and older individuals. Overall, studies have provided the most support for the modality of therapeutic exercise. Different physical modalities have similar magnitudes of effects on chronic pain. Therefore, selection of the most appropriate physical modality may depend on the desired functional outcome for the patient, the underlying impairment, and the patient's preference or prior experience with the modality. Certain patient characteristics may decrease the effectiveness …
Split-Thickness Skin Graft Donor Site Care: A Quantitative Synthesis Of The Research, Barbara Rakel, M. Bermel, L. Abbott, S. Baumler, M. Burger, C. Dawson, J. Heinle, I. Ocheltree
Split-Thickness Skin Graft Donor Site Care: A Quantitative Synthesis Of The Research, Barbara Rakel, M. Bermel, L. Abbott, S. Baumler, M. Burger, C. Dawson, J. Heinle, I. Ocheltree
Barbara A. Rakel
Split-thickness skin grafting (STSG) is a frequently used reconstructive technique but is associated with a large variation in practice. The purposes of this article are to integrate and synthesize the available empirical evidence regarding STSG donor site dressings, identify which dressings are associated with the best outcomes, and provide practice recommendations. This review of 33 studies found transparent film to be the best dressing for the care of STSG donor site wounds. Transparent film was associated with one of the fastest healing rates (9.47 days), a smooth epithelialized surface, a low infection rate (10 out of 394 patients or 3%), …
Development Of Alterations In Learning: Situational Learning Disabilities, Barbara Rakel, G. Bulechek
Development Of Alterations In Learning: Situational Learning Disabilities, Barbara Rakel, G. Bulechek
Barbara A. Rakel
Until now the nursing diagnosis knowledge deficit has served as a label for all teaching/learning situations. This is inadequate and does not effectively give direction to correct intervention(s). The purpose of this article is to present the diagnostic concept, situational learning disability (SLD), a component of Alterations in Learning, which has been identified as an area to be developed in the Knowing pattern of the NANDA taxonomy. A thorough review of the literature and empirical support involving 20 cardiology patients on a 27-bed telemetry step-down unit is provided. The data support the development of two nursing diagnoses: (1) situational learning …
Implementation Of The Agency For Health Care Policy And Research Pain Guidelines, K. Schmidt, M. Alpen, Barbara Rakel
Implementation Of The Agency For Health Care Policy And Research Pain Guidelines, K. Schmidt, M. Alpen, Barbara Rakel
Barbara A. Rakel
Implementation of clinical practice guidelines in a large setting is a complex process. This article describes the many issues encountered in trying to implement Agency for Health Care Policy and Research acute pain and cancer pain guidelines in an academic medical center. Issues addressed include the membership of the task forces involved, incorporation of the guidelines into the institution-specific standards of care, selection and implementation of self-reporting tools for assessment of pain throughout the institution, issues involved in standardizing documentation of pain throughout the institution, measurement of the current status of pain control and integration into the existing quality assessment …
Effectiveness Of Transcutaneous Electrical Nerve Stimulation For Treatment Of Hyperalgesia And Pain, J. Desantana, D. Walsh, C. Vance, Barbara Rakel, K. Sluka
Effectiveness Of Transcutaneous Electrical Nerve Stimulation For Treatment Of Hyperalgesia And Pain, J. Desantana, D. Walsh, C. Vance, Barbara Rakel, K. Sluka
Barbara A. Rakel
Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacologic treatment for pain relief. TENS has been used to treat a variety of painful conditions. This review updates the basic and clinical science regarding the use of TENS that has been published in the past 3 years (ie, 2005-2008). Basic science studies using animal models of inflammation show changes in the peripheral nervous system, as well as in the spinal cord and descending inhibitory pathways, in response to TENS. Translational studies show mechanisms to prevent analgesic tolerance to repeated application of TENS. This review also highlights data from recent randomized, placebo-controlled trials …