Nursing Commons^™

Caregiving Factors Affecting Breastfeeding Duration Within A Neonatal Intensive Care Unit., Sharon G. Casavant, Georgine Burke, Carrie-Ellen Briere, Jacqueline Mcgrath

Carrie-Ellen Briere

Abstract Background: Increasingly, evidence supports oral feeding of very-low-birth-weight (VLBW) preterm infants exclusively at breast or with breastmilk. Despite known breastmilk benefits, outcomes related to exclusive breastmilk provision are poor. Identifying factors that promote breastmilk provision is critical. Purpose: Breastfeeding practices of mothers of VLBW infants admitted to neonatal intensive care unit (NICU) were explored to identify factors associated with mode of feeding at discharge. Method: This retrospective study replicates previous work. Subjects were VLBW preterm infants consecutively admitted during a 24-month period. Primary outcomes included receiving any breastmilk at discharge. Infant variables included gestational age (GA), post-menstrual age (PMA) …

Critical Illness Myopathy, Salima Moez Meherali, Yasmin Parpio, Tazeen Ali

Tazeen Ali

Critical illness myopathy (CIM) is a syndrome of widespread muscle weakness and neurological dysfunction which can develop in critically ill patients receiving intensive care. CIM are often distinguished largely on the basis of specialized electrophysiologic testing or muscle and nerve biopsy and its causes are unknown, though they are thought to be a possible neurological manifestation of systemic inflammatory response syndrome usually developing in patients after a brief period of stay in the Intensive Care Unit (ICU). This case report aims to analyze the Clinical feature, diagnosis and treatment of CIM of 60 years old male case with Chronic Obstructive …

Prognostic Value Of Heart Rate Turbulence For Risk Assessment In Patients With Unstable Angina And Non-St Elevation Myocardial Infarction, Patricia R.E. Harris, Phyllis K. Stein, Gordon L. Fung, Barbara J. Drew

Patricia Harris

Background: We sought to examine the prognostic value of heart rate turbulence derived from electrocardiographic recordings initiated in the emergency department for patients with non-ST elevation myocardial infarction (NSTEMI) or unstable angina. Methods: Twenty-four-hour Holter recordings were started in patients with cardiac symptoms approximately 45 minutes after arrival in the emergency department. Patients subsequently diagnosed with NSTEMI or unstable angina who had recordings with ≥18 hours of sinus rhythm and sufficient data to compute Thrombolysis In Myocardial Infarction (TIMI) risk scores were chosen for analysis (n = 166). Endpoints were emergent re-entry to the cardiac emergency department and/or death at …

Heart Rate Variability Measured Early In Patients With Evolving Acute Coronary Syndrome And 1-Year Outcomes Of Rehospitalization And Mortality, Patricia R.E. Harris, Phyllis K. Stein, Gordon L. Fung, Barbara J. Drew

Patricia Harris

Objective: This study sought to examine the prognostic value of heart rate variability (HRV) measurement initiated immediately after emergency department presentation for patients with acute coronary syndrome (ACS). Background: Altered HRV has been associated with adverse outcomes in heart disease, but the value of HRV measured during the earliest phases of ACS related to risk of 1-year rehospitalization and death has not been established. Methods: Twenty-four-hour Holter recordings of 279 patients with ACS were initiated within 45 minutes of emergency department arrival; recordings with �18 hours of sinus rhythm were selected for HRV analysis (number [N] �193). Time domain, frequency …

Insights Into The Problem Of Alarm Fatigue With Physiologic Monitor Devices: A Comprehensive Observational Study Of Consecutive Intensive Care Unit Patients, Barbara J. Drew, Patricia Harris, Jessica K. Zègre-Hemsey, Tina Mammone, Daniel Schindler, Rebeca Salas-Boni, Yong Bai, Adelita Tinoco, Quan Ding, Xiao Hu

Patricia Harris

Purpose: Physiologic monitors are plagued with alarms that create a cacophony of sounds and visual alerts causing ‘‘alarm fatigue’’ which creates an unsafe patient environment because a life-threatening event may be missed in this milieu of sensory overload. Using a state-of-the-art technology acquisition infrastructure, all monitor data including 7 ECG leads, all pressure, SpO2, and respiration waveforms as well as user settings and alarms were stored on 461 adults treated in intensive care units. Using a well-defined alarm annotation protocol, nurse scientists with 95% inter-rater reliability annotated 12,671 arrhythmia alarms. Results: A total of 2,558,760 unique alarms occurred in the …

Prognostic Value Of Heart Rate Turbulence For Risk Assessment In Patients With Unstable Angina And Non-St Elevation Myocardial Infarction, Patricia R.E. Harris, Phyllis K. Stein, Gordon L. Fung, Barbara J. Drew

Patricia Harris

Background: We sought to examine the prognostic value of heart rate turbulence derived from electrocardiographic recordings initiated in the emergency department for patients with non-ST elevation myocardial infarction (NSTEMI) or unstable angina. Methods: Twenty-four-hour Holter recordings were started in patients with cardiac symptoms approximately 45 minutes after arrival in the emergency department. Patients subsequently diagnosed with NSTEMI or unstable angina who had recordings with ≥18 hours of sinus rhythm and sufficient data to compute Thrombolysis In Myocardial Infarction (TIMI) risk scores were chosen for analysis (n = 166). Endpoints were emergent re-entry to the cardiac emergency department and/or death at …

Insights Into The Problem Of Alarm Fatigue With Physiologic Monitor Devices: A Comprehensive Observational Study Of Consecutive Intensive Care Unit Patients, Barbara J. Drew, Patricia Harris, Jessica K. Zègre-Hemsey, Tina Mammone, Daniel Schindler, Rebeca Salas-Boni, Yong Bai, Adelita Tinoco, Quan Ding, Xiao Hu

Patricia Harris

Purpose: Physiologic monitors are plagued with alarms that create a cacophony of sounds and visual alerts causing ‘‘alarm fatigue’’ which creates an unsafe patient environment because a life-threatening event may be missed in this milieu of sensory overload. Using a state-of-the-art technology acquisition infrastructure, all monitor data including 7 ECG leads, all pressure, SpO2, and respiration waveforms as well as user settings and alarms were stored on 461 adults treated in intensive care units. Using a well-defined alarm annotation protocol, nurse scientists with 95% inter-rater reliability annotated 12,671 arrhythmia alarms.

Results: A total of 2,558,760 unique alarms occurred in the …

A Tool To Assess The Signs And Symptoms Of Catheter-Associated Urinary Tract Infection: Development And Reliability, Thomas Blodgett, Sue Gardner, Nicole Blodgett, Lisa Peterson, Melissa Pietraszak

Thomas Blodgett

The purpose of this pilot study was to determine the inter-rater reliability of four clinical manifestations of catheter-associated urinary tract infections (CAUTI) among hospitalized adults with short-term indwelling urinary catheters using a tool developed for this purpose: the CAUTI Assessment Profile (CAP). Study participants included 30 non-pregnant English-speaking adults, recruited from 2 community hospitals. Three nurses assessed each participant for fever, suprapubic tenderness, flank tenderness, and delirium using standardized techniques. Based on the generalized kappa statistic and 95% confidence intervals, there was evidence of strong inter-rater reliability for fever (kappa = 1.00, 0.793 – 1.207), suprapubic tenderness (kappa = 0.39, …

A Comunicação Da Equipe De Enfermagem Com O Paciente Em Cuidados Paliativos; The Communication Of The Nursing Team With Patients In Palliative Care, Everton Fernando Alves

Everton Fernando Alves

The article consists of a contextualized reflection on the communication in palliative care with the purpose of explaining strategies used for effective communication among the nursing, terminally ill and his family. In that sense, it was observed that for the nurse to assist the terminally ill is a difficult task, which raises sensation of sadness, frustration, impotence and even failure in the rendered attendance. This way, many professionals use denial, escaping, and the apparent coldness as defense mechanisms to cope with situation. Throughout this discussion are exposed some aspects that enable developing empathic communication skills, perceived as a task that …

O Cuidador De Enfermagem E O Cuidar Em Uma Unidade De Terapia Intensiva / The Nursing Caregiver And The Caring In Intensive Care Units, Everton Alves

Everton Fernando Alves

Diversos fatores são considerados agressivos em uma Unidade de Terapia Intensiva (UTI), os quais não atingem apenas os pacientes, mas também os cuidadores de enfermagem, uma vez que estes participam desde procedimentos complexos até morte de pacientes. Dessa forma, muitos cuidadores de enfermagem passam por dificuldades em sua rotina diária que influenciam o modo de cuidar. O objetivo deste estudo foi identificar os aspectos vivenciados pelos cuidadores de enfermagem que atuam em uma UTI - Adulto. Trata-se de um estudo exploratório-descritivo, de abordagem qualitativa, desenvolvido junto a 21 cuidadores de enfermagem da UTI - Adulto de um hospital escola do …

Qualidade De Vida Do Cuidador De Enfermagem E Sua Relação Com O Cuidar / Quality Of Life Of The Nursing Caregiver And Its Relationship With Care, Everton Fernando Alves

Everton Fernando Alves

Objective:To identify aspects that affect the quality of life of nursing caregivers and their relationship with care in an Intensive Care Unit for Adults (A-ICU). Methods:This was a descriptive study with qualitative approach, taking as subjects 21 professionals who constitute the nursing staff of the A-ICU of a school hospital in Maringá-PR. Unstructured interview was used as a strategy to collect data, conducted between May and June 2009. Data analysis was based on the method of content analysis. The categories identified were: overlooking improvement in quality of life related to the resources in an A-ICU; the quality of life influencing …

Análise Da Produção Bibliográfica Sobre Qualidade De Vida De Portadores De Feridas Crônicas / Bibliographical Analysis On Quality Of Life Of Patients With Chronic Wounds, Everton Alves, Edilson De Albuquerque

Everton Fernando Alves

O estudo teve como objeto analisar algumas características da produção bibliográfica sobre a Qualidade de Vida (QV) de portadores de Feridas Crônicas (FC) no Brasil entre 2000 e 2009. Para tanto, realizou-se uma revisão sistemática da literatura através da busca de estudos indexados nas bases de dados da BIREME. Os materiais encontrados e utilizados foram sete artigos, uma dissertação e uma tese. Destes, a maioria dos artigos se concentrou no ano de 2001 e 2006, correspondendo a 50% das publicações levantadas. Os resultados demonstraram que apenas uma publicação, ou seja, (16,6%) dos dados, foi encontrada na Revista Ciencia y Enfermería …

Características Dos Acidentes De Trânsito Com Vítimas De Atropelamento No Município De Maringá-Pr, 2005-2008 / Characteristics Of Traffic Accidents From 2005 To 2008 With Run Over Victims In Maringá, Pr, Brazil., Everton Fernando Alves

Everton Fernando Alves

Trata-se de um estudo retrospectivo descritivo, que teve por objetivo conhecer as características dos acidentes de trânsito por atropelamento no município de Maringá entre 2005 e 2008. Para o estudo foram consideradas as vítimas de acidentes de trânsito por atro-pelamentos ocorridos em Maringá, no período de 2005 a 2008, através dos dados do Registro Geral de Ocorrência – RGO do 5º Grupamento de Bombeiros (GB). Foram identificadas 1841 vítimas. Do total de víti-mas, foi estudado o número de ocorrências registradas (1486), distribu-ídos em 399 no ano de 2005, 376 em 2006, 361 em 2007 e 350 no ano de 2008. …