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 …

Patient Experience Measurement Ignores Mental Health: Suggestions For Healthcare Organizations, Mona Shattell Phd, Rn, Faan, Andrew Gallan Phd

Mona Shattell

No abstract provided.

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 …

Intergrative Review Of Palliative Care In End Stage Heart Failure, Joyce K. Kutin

Joyce K Kutin RN, MSN, MOL

The aim of this integrative literature review is to explore and discuss palliative care placement within the trajectory of heart failure in the end stage process. After an extensive search through 200 peer-reviewed studies published from 2009-2013 in the following databases: CINAHL, Academic Search Elite, Health Source Consumer Source Edition, Health Source: Nursing/Academic Edition, MEDLINE, Academic Collection (EBSCOhost), seven articles meeting the constraints were chosen.. Common themes of these studies concern symptom management, medication administration, and decision-making tools for assessing patient centered needs and future research regarding effective implementation of palliative care integration in end stage heart failure patients. Nurses …

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 …

Qualidade De Vida De Estudantes De Enfermagem De Uma Faculdade Privada / Quality Of Life Of Undergraduate Nursing Students From A Private University, Everton Fernando Alves

Everton Fernando Alves

O presente estudo teve como objetivo avaliar a qualidade de vida dos estudantes no curso de Enfermagem de uma faculdade privada. Realizou-se um estudo descritivo, com abordagem quantitativa, utilizando a Escala de Qualidade de Vida de Flanagan e um instrumento de coleta de dados complementares, contendo questões estruturadas. Resultou numa amostra de 192 (cento e noventa e dois) estudantes. O diagnóstico evidenciou que a maioria dos estudantes está „Satisfeitos‟ e „Pouco satisfeitos‟ com a sua qualidade de vida, entretanto identificou a presença de vários problemas que necessitam de atenção dos educadores. Concluiu-se que se faz necessária a formação de um …

Relationship Between Precipitant Stressor And Timing Of Clinical Diagnosis In Tako-Tsubo Cardiomyopathy., C Neil, Angela M. Kucia, H Nguyen, A Sverdlov, A Chan, D Dautov, I Mohasseb, J Selvanayagam, M Arstall, C Zeitz, J Beltrame, J Horowitz

Angela Kucia

In practice, TTC is diagnosed almost exclusively either via (1) emergency cardiac catheterisation, primarily for apparent 'STEMI', or (2) recognition of a potentially precipating stress, primarily in patients with a non-ST-elevation (N-STE) ECG pattern. We therefore hypothesized that the greatest delays in diagnosis would occur in the subgroup with N-STE and no known stressor. A seasonality analysis was also undertaken, to test a possible association between heat stress and TTC.

Evolution Of Ecg Changes In Tako Tsubo Cardiomyopathy: Arrhythmias First, Qt Prolongation Later?, Angela M. Kucia, C Neil, T Nguyen, J Beltrame, M Arstall, J Horowitz

Angela Kucia

Electrocardiographic changes previously described in Tako Tsubo Cardiomyopathy (TTC) include T-wave inversion with QTc prolongation, but the relationship of these changes to the evolution of TTC is uncertain. Furthermore, torsade de pointes (TdP) has been reported to occur, but its relationship to QT prolongation in TTC is unclear.

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. …

Embodied Work: Insider Perspectives On The Work Of Hiv/Aids Peer Counselors, D.K. Messias, L Moneyham, M. Vyavaharkar, C. Murdaugh, Kenneth D. Phillips

Kenneth D. Phillips

Our aim in this study was to explore HIV/AIDS peer counseling from the perspective of women actively engaged in this work within the context of a community-based program in rural areas of the southeastern United States. Based on this research we suggest that the embodied work of HIV/AIDS peer counselors is constructed around their personal identities and experiences. This work involves gaining entry to other HIV-positive women’s lives, building relationships, drawing on personal experiences, facing issues of fear and stigma, tailoring peer counseling for diversity, balancing risks and benefits, and terminating relationships. Peer counselors recognize the personal and collective value …

Secondary Prevention For Acute Coronary Syndrome In Rural South Australia: Are Drugs Best? What About The Rest?, Tracey Wachtel, Angela Kucia, Jennene Greenhill

Angela Kucia

Acute coronary syndrome (ACS) is a major cause of morbidity and mortality worldwide. Current Australian clinical guidelines recommend all patients with ACS receive comprehensive secondary prevention services to address this burden. Optimal patient outcomes rely on the timely and effective implementation of proven therapies and for secondary prevention to be successful, pharmcological interventions must be combined with cardiovascular disease (CVD) risk factor identification and management. The ability to implement clinical guidelines is also reliant on available resources, yet many rural populations in Australia do not have access to structured secondary prevention services, and the level of support available to them …

Continuous St/T Wave Monitoring During An Acute Coronary Syndrome Presentation In Patients With The Coronary Slow Flow Phenomenon (Csfp), Natalie Cutri, Angela Kucia, John F. Beltrame

Angela Kucia

The coronary slow flow phenomenon (CSFP) is a coronary microvascular disorder that typically presents as an acute coronary syndrome and is characterised by delayed vessel opification on angiography in the absence of obstructive coronary artery disease. This study compared the frequency of the ST segment (STs) and T wave (TW) change during continuous ST/T wave monitoring in healthy controls and patients with the CSFP.

The Effects Of Positional Changes On T Wave Amplitude In Healthy Subjects, Natalie Cutri, John F. Beltrame, Angela M. Kucia

Angela Kucia

ST segment (STs) and T wave (Tw) changes are markers of myocardial ischaemia. However, STs changes have been reported with changes in body position. The effect of body position on Tw changes is unknown and the objective of this study.

Moderate Intensity Exercise Training Reverses Functional Aerobic Impairment In Hiv-Infected Individuals, Kenneth D. Phillips`

Kenneth D. Phillips

No abstract provided.

Creativity In Older Adults: A Plethora Of Possibilities, Kenneth D. Phillips

Kenneth D. Phillips

No abstract provided.

Social Support, Coping, And Medication Adherence Among Hiv-Positive Women With Depression Living In Rural Areas Of The Southeastern United States, Kenneth D. Phillips

Kenneth D. Phillips

No abstract provided.

A Look At Tuberculosis And Its Relationship To Hiv/Aids, Kenneth D. Phillips

Kenneth D. Phillips

No abstract provided.

Perceived Stress In Hiv-Infected Individuals: Physiological And Psychological Correlates, Kenneth D. Phillips

Kenneth D. Phillips

No abstract provided.

Alcohol And Other Drug Disorders, Comorbidity And Violence In Rural African American Women, Kenneth D. Phillips

Kenneth D. Phillips

No abstract provided.

Hiv/Aids Peer Counselors' Perspectives On Intervention Delivery Formats, Kenneth D. Phillips

Kenneth D. Phillips

No abstract provided.

Counteracting Muscle Wasting In Hiv-Infected Individuals, Kenneth D. Phillips

Kenneth D. Phillips

No abstract provided.