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Articles 1 - 20 of 20
Full-Text Articles in Nursing
Diabetes And Inflammation In Infected Chronic Wounds, Sue Gardner, Rita Frantz, Charles Saltzman
Diabetes And Inflammation In Infected Chronic Wounds, Sue Gardner, Rita Frantz, Charles Saltzman
Rita A. Frantz
Objective. This study examined the impact of diabetes on inflammatory responses among individuals with infected chronic wounds. The findings provide evidence of the extent to which infection may, go unrecognized among persons with diabetes. Methods. This' study was a secondary analysis of another study. Chronic wounds were assessed for signs of infection and classified as infected or noninfected based on quantitative cultures of wound tissue. Infected wounds were those with greater than 10(5) organisms per gram of wound tissue or containing P-hemolytic Streptococcus. Diabetes status was determined through medical record review. The classical signs of inflammation (ie, pain, erythema, edema, …
How Accurate Are Chronic Wound Assessments Using Interactive Video Technology?, Sue Gardner, Rita Frantz, Janet Specht, J. Johnson-Mekota, K. Buresh, B. Wakefield, J. Flanagan
How Accurate Are Chronic Wound Assessments Using Interactive Video Technology?, Sue Gardner, Rita Frantz, Janet Specht, J. Johnson-Mekota, K. Buresh, B. Wakefield, J. Flanagan
Rita A. Frantz
This project examined the accuracy of chronic wound assessments made using an interactive, video telecommunications system (Teledoc 5000, NEC America, Inc., Irving, TX) by comparing a nurse expert's in-person wound assessments with wound assessments made from taped Teledoc sessions. Wound assessments determined the absence or presence of nine wound characteristics instrumental in guiding treatment (e.g., tunneling, undermining, granulation tissue, necrotic tissue, epithelial tissue, purulent exudate, erythema, edema, induration). A sample of 13 paired wound observations was analyzed. The accuracy of the Teledoc technology was examined by calculating the amount of agreement between the in-person assessments and the taped Teledoc assessments …
Clinical Signs Of Infection In Diabetic Foot Ulcers With High Microbial Load, Sue Gardner, S. Hillis, Rita Frantz
Clinical Signs Of Infection In Diabetic Foot Ulcers With High Microbial Load, Sue Gardner, S. Hillis, Rita Frantz
Rita A. Frantz
One proposed method to diagnose diabetic foot ulcers (DFUs) for infection is clinical examination. Twelve different signs of infection have been reported. The purpose of this study was to examine diagnostic validity of each individual clinical sign, a combination of signs recommended by the Infectious Disease Society of America (IDSA), and a composite predictor based on all signs of localized wound infection in identifying DFU infection, among a sample of DFUs. Methods. A cross-sectional research design was used. Sixty-four individuals with DFUs were recruited from a Department of Veterans Affairs Medical Center and an academic-affiliated hospital. Each DFU was independently …
A Tool To Assess Clinical Signs And Symptoms Of Localized Infection In Chronic Wounds: Development And Reliability., Sue Gardner, Rita Frantz, C. Troia, S. Eastman, M. Macdonald, K. Buresh, D. Healy
A Tool To Assess Clinical Signs And Symptoms Of Localized Infection In Chronic Wounds: Development And Reliability., Sue Gardner, Rita Frantz, C. Troia, S. Eastman, M. Macdonald, K. Buresh, D. Healy
Rita A. Frantz
This paper reports on the development and testing of a tool designed to assess chronic wounds for the clinical signs and symptoms of localized infection. Thirty-one wounds were assessed by two independent nurse observers for the signs and symptoms of infection using the Clinical Signs and Symptoms Checklist. The Clinical Signs and Symptoms Checklist delineates 12 signs and symptoms of infection (i.e., pain, erythema, edema, heat, purulent exudate, serous exudate with concurrent inflammation, delayed healing, discoloration of granulation tissue, friable granulation tissue, pocketing at the base of the wound, foul odor, and wound breakdown) and their definitions. The reliability of …
The Inter-Rater Reliability Of The. Clinical Signs And Symptoms Checklist In Diabetic Foot Ulcers, Sue Gardner, Rita Frantz, H. Park, M. Scherubel
The Inter-Rater Reliability Of The. Clinical Signs And Symptoms Checklist In Diabetic Foot Ulcers, Sue Gardner, Rita Frantz, H. Park, M. Scherubel
Rita A. Frantz
The Clinical Signs and Symptoms Checklist is a tool designed to measure 12 clinical signs and symptoms of localized chronic wound infection. Since its initial development, this Checklist has been revised to include sanguineous drainage. To examine the inter-rater reliability of the revised Clinical Signs and Symptoms Checklist in diabetic foot ulcers, an observational, cross-sectional study was conducted in conjunction with a larger study examining the validity of each sign and symptom for identifying infection in diabetic foot ulcers. Two independent nurse observers assessed 64 diabetic foot ulcers in 64 patients using the Checklist. The reliability of each item was …
Effect Of Electrical Stimulation On Chronic Wound Healing: A Meta-Analysis, Sue Gardner, Rita Frantz, F. Schmidt
Effect Of Electrical Stimulation On Chronic Wound Healing: A Meta-Analysis, Sue Gardner, Rita Frantz, F. Schmidt
Rita A. Frantz
The purpose of this meta-analysis was to quantify the effect of electrical stimulation on chronic wound healing. Fifteen studies, which included 24 electrical stimulation samples and 15 control samples, were analyzed. The average rate of healing per week was calculated for the electrical stimulation and control samples. Ninety-five percentage confidence intervals were also calculated. The samples were then grouped by type of electrical stimulation device and chronic wound and reanalyzed. Rate of healing per week was 22% for electrical stimulation samples and 9% for control samples. The net effect of electrical stimulation was 13% per week, an increase of 144% …
Elderly Skin Care: Principles Of Chronic Wound Care, Rita Frantz, Sue Gardner
Elderly Skin Care: Principles Of Chronic Wound Care, Rita Frantz, Sue Gardner
Rita A. Frantz
1. Chronic wounds are a frequently encountered problem in elders. Chronic wounds are characterized by loss of skin or underlying soft tissue and do not progress toward healing with conventional wound care treatment. 2. There are four basic principles of chronic wound care: remove debris and cleanse the wound; provide a moist wound healing environment through the use of proper dressings; protect the wound from further injury; and provide substrates essential to the wound healing process. 3. Underlying the care of chronic wounds is the necessity to assess the wound on an ongoing basis. Changes in wound care must be …
Integration Of Pressure Ulcer Treatment Protocol Into Practice: Clinical Outcomes And Care Environment Attributes., Rita Frantz, Sue Gardner, Janet Specht, G. Mcintire
Integration Of Pressure Ulcer Treatment Protocol Into Practice: Clinical Outcomes And Care Environment Attributes., Rita Frantz, Sue Gardner, Janet Specht, G. Mcintire
Rita A. Frantz
The purpose of this study was to determine if a research-based protocol for pressure ulcer treatment that had been successfully implemented in a long-term care facility was sustained over time. A secondary aim was to describe the attributes of the care environment that may have contributed to or impeded the maintenance of this protocol. A retrospective chart review was conducted of all patients who developed incident stage II, III, or IV pressure ulcers in the facility over a one-year period five years after initial implementation of a pressure ulcer treatment protocol. Data regarding ulcer characteristics and type, frequency, and duration …
A Prospective Study Of The Pressure Ulcer Scale For Healing (Push), Sue Gardner, Rita Frantz, S. Bergquist, C. Shin
A Prospective Study Of The Pressure Ulcer Scale For Healing (Push), Sue Gardner, Rita Frantz, S. Bergquist, C. Shin
Rita A. Frantz
Background. Although the recently developed Pressure Ulcer Scale for Healing (PUSH) was created to monitor healing over time, prospective evidence of its validity in measuring healing is lacking. The purpose of this study was to assess the validity of PUSH (version 3.0) when used to assess pressure ulcers in clinical practice. Methods. The authors chose a prospective research design using a convenience sample of nursing home residents with pressure ulcers. The patients' pressure ulcers were assessed each week with the PUSH and the Pressure Sore Status Tool. Surface area measurements derived from wound tracings were also obtained. Weekly assessments continued …
A Pilot Study Of Immune And Mood Outcomes Of A Community-Based Intervention For Dementia Caregivers: The Plst Intervention, L. Garand, Kathleen Buckwalter, D. Lubaroff, Toni Tripp-Reimer, Rita Frantz, T. Ansley
A Pilot Study Of Immune And Mood Outcomes Of A Community-Based Intervention For Dementia Caregivers: The Plst Intervention, L. Garand, Kathleen Buckwalter, D. Lubaroff, Toni Tripp-Reimer, Rita Frantz, T. Ansley
Rita A. Frantz
Providing care to a family member with dementia is conceptualized as a chronic stressor with adverse psychological and physical effects. The purpose of this pilot study was to evaluate mood and immune outcomes of caregivers exposed to a community-based psychoeducational nursing intervention based on the progressively lowered stress threshold (PLST) model. The PLST intervention is designed to strengthen the psychological resources of dementia caregivers by teaching methods of preventing and/or managing behavioral problems exhibited by the person with dementia. Mood and immune outcomes were compared between caregivers randomly assigned to receive either the PLST or a comparison intervention. Results of …
Staphylococcus Aureus Is Associated With High Microbial Load In Chronic Wounds, Sue Gardner, Rita Frantz, Charles Saltzman, K. Dodgson
Staphylococcus Aureus Is Associated With High Microbial Load In Chronic Wounds, Sue Gardner, Rita Frantz, Charles Saltzman, K. Dodgson
Rita A. Frantz
The purpose of this study was to describe the association of Staphylococcus aureus with clinical and microbiological indicators of localized infection in a sample of chronic wounds. Sixty-six subjects with chronic wounds were assessed for signs and symptoms of localized infection, and viable wound tissue spec mens were obtained for quantitative microbiological analyses. The study wounds were then grouped according to whether or not they contained S. aureus, and statistically compared for differences in the expression of clinical signs of infection, microbial load (i.e., number of organisms per gram of tissue), and diversity of species (i.e., number of different species …
Diagnostic Validity Of Semiquantitative Swab Cultures, Sue Gardner, Rita Frantz, S. Hillis, H. Park, M. Scherubel
Diagnostic Validity Of Semiquantitative Swab Cultures, Sue Gardner, Rita Frantz, S. Hillis, H. Park, M. Scherubel
Rita A. Frantz
Swab cultures of wounds are noninvasive and most laboratories are capable of semiquantitatively processing these specimens. This study examined the diagnostic validity of semiquantitative swab cultures obtained using Levine's technique and compared semiquantitative and quantitative swab cultures. Two swab specimens were obtained from a sample of 44 chronic wounds using Levine's technique. One was processed using quantitative laboratory procedures and the other using semiquantitative laboratory procedures. The diagnostic validity of the findings from each swab culture process was determined by associating the culture findings of each with quantitative tissue cultures (reference standard) using receiver operating characteristic (ROC) curves and by …
A Nursing Application Of Telecommunications. Measurement Of Satisfaction For Patients And Providers., J. Mass M Johnson-Mekota, K. Buresh, Sue Gardner, R. Frantz, Janet Specht, B. Wakefield, J. Flanagan
A Nursing Application Of Telecommunications. Measurement Of Satisfaction For Patients And Providers., J. Mass M Johnson-Mekota, K. Buresh, Sue Gardner, R. Frantz, Janet Specht, B. Wakefield, J. Flanagan
Rita A. Frantz
Consumer and provider satisfaction is key to the continued use and expansion of telehealth technology. This pilot study compared satisfaction of providers and patients with wound consultations done in person with those done via real-time interactive video technology. Eleven telehealth consultations with a nurse expert were immediately followed by an in-person consultation with a second nurse expert. Satisfaction questionnaires were administered to patients, referring nurses, and the consultant nurse expert following both the in-person consultation and the telehealth consultation. The referring nurses (100%) were satisfied with both the telehealth and in-person consultations, noting the ability to provide better care for …
Nursing Assessment: Impact On Type And Cost Of Interventions To Prevent Pressure Ulcers, G. Richardson, Sue Gardner, Rita Frantz
Nursing Assessment: Impact On Type And Cost Of Interventions To Prevent Pressure Ulcers, G. Richardson, Sue Gardner, Rita Frantz
Rita A. Frantz
Objective: To describe pressure ulcer preventive interventions and their cost, and to compare the preventive intervention use and cost with level of risk. Design: Comparative, descriptive design. Setting and Subjects: A large midwestern Veteran's Affairs Medical Center with 260 long-term care beds. Thirty-one chair- or bed-bound residents from 1 long-term care unit comprised the study sample. Main Outcome Measures: The outcome variables included demographic information (patient record), Braden Risk Assessment score, institutional risk assessment score (Pressure Ulcer Risk Tool), type and frequency of preventive interventions, and the related costs. Methods: Subjects were assessed on a weekly basis for type and …
Clinical Concerns: Management Of Dry Skin, Rita Frantz, Sue Gardner
Clinical Concerns: Management Of Dry Skin, Rita Frantz, Sue Gardner
Rita A. Frantz
No abstract provided.
The Validity Of The Clinical Signs And Symptoms Used To Identify Localized Chronic Wound Infection, Sue Gardner, Rita Frantz, B. Doebbeling
The Validity Of The Clinical Signs And Symptoms Used To Identify Localized Chronic Wound Infection, Sue Gardner, Rita Frantz, B. Doebbeling
Rita A. Frantz
It is uncertain how accurately classic signs of acute infection Identify infection in chronic wounds, or if the signs of infection specific to secondary wounds are better indicators of infection in these wounds. The purpose of this study was to examine the validity of the ''classic" signs (i.e., pain, erythema, edema, heat, and purulence) and the signs specific to secondary wounds (i.e serous exudate, delayed healing, discoloration of granulation tissue, friable granulation tissue, pocketing at the base of the,wound, lout odor, and wound breakdown). Thirty-six chronic wounds were assessed for these signs and symptoms of infection with interobserver reliability ranging …
Obtaining Wound Specimens: 3 Techniques, Sue Gardner, Rita Frantz
Obtaining Wound Specimens: 3 Techniques, Sue Gardner, Rita Frantz
Rita A. Frantz
No abstract provided.
The Cost Of Treating Pressure Ulcers Following Implementation Of A Research-Based Skin Care Protocol In A Long-Term Care Facility, Rita Frantz, S. Bergquist, Janet Specht
The Cost Of Treating Pressure Ulcers Following Implementation Of A Research-Based Skin Care Protocol In A Long-Term Care Facility, Rita Frantz, S. Bergquist, Janet Specht
Rita A. Frantz
Although concern for the costs associated with pressure ulcer treatments persists, studies that precisely quantify costs are limited. A retrospective research design was used to describe the costs incurred by an 830-bed, long-term care facility to treat 81 pressure ulcers over a one-year period following implementation of a research-based, skin care protocol. The total cost for the study period was $30,079 with 73% of these expenditures attributable to nursing care. Mean cost of treatment was $3.74/pressure ulcer/day, which was a reduction from the $5.35/pressure ulcer/day cost prior to implementation of the skin care protocol. These findings suggest that implementing a …
Adoption Of Research-Based Practice For Treatment Of Pressure Ulcers In Long-Term Care., Rita Frantz, Sue Gardner, P. Harvey, Janet Specht
Adoption Of Research-Based Practice For Treatment Of Pressure Ulcers In Long-Term Care., Rita Frantz, Sue Gardner, P. Harvey, Janet Specht
Rita A. Frantz
Implementation of a clinical trial to evaluate the effectiveness of electrotherapy on pressure ulcer healing provided the stimulus for adoption of research-based innovations for pressure ulcer treatment in one long-term care facility. A five-year retrospective study conducted prior to introduction of the clinical trial revealed that 72 different treatments were applied to pressure ulcers. Forty-two percent of the pressure ulcers were left open to the air or covered with a dry gauze dressing and 64% were treated with some type of antiseptic solution. Since implementation of the clinical trial and the accompanying access to wound healing research knowledge it provided …
Diagnostic Validity Of Three Swab Techniques For Identifying Chronic Wound Infection, Sue Gardner, Rita Frantz, Charles Saltzman, S. Hillis, H. Park, M. Scherubel
Diagnostic Validity Of Three Swab Techniques For Identifying Chronic Wound Infection, Sue Gardner, Rita Frantz, Charles Saltzman, S. Hillis, H. Park, M. Scherubel
Rita A. Frantz
This study examined the diagnostic validity of three different swab techniques in identifying chronic wound infection. Concurrent swab specimens of chronic wounds were obtained using wound exudate, the Z-technique, and the Levine technique, along with a specimen of viable wound tissue. Swab and tissue specimens were cultured using quantitative and qualitative laboratory procedures. Infected wounds were defined as those containing 1 x 10(6) or more organisms per gram of tissue. Accuracy was determined by associating the quantitative cultures of swab specimens with the cultures from tissue specimens using receiver operating characteristic curves. Of the 83 study wounds, 30 (36%) were …