摘要:

Electrical stimulation is frequently recommended for the treatment of urinary incontinence in men. However, few randomized, controlled trials allow practitioners to evaluate the evidence base for this practice. The purpose of this article is to determine, based on a review of the literature, whether adequate evidence exists to support the use of electrical stimulation as a treatment of male urinary incontinence. Urge, stress, and overflow incontinence are evaluated separately. This review led to 3 conclusions: (1) theoretical and urodynamic evidence exists to support the use of electrical stimulation for urge incontinence, (2) conflicting evidence exists in the use of electrical stimulation for stress urinary incontinence, and (3) treatment of overflow incontinence in men has not been evaluated in a systematic way. For both stress urinary or overflow incontinence, practitioners should consider the existing research before recommending electrical stimulation as a first line of treatment. For urge incontinence, electrical stimulation may be an effective first-line treatment strategy.

ISSN:1071-5754    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Glutamine is the most abundant free amino acid in the body. It is synthesized and stored in skeletal muscle and released in significant amounts during times of stress. Glutamine is primarily used by rapidly replicating cells such as enterocytes, lymphocytes, macrophages, and fibroblasts. The role of glutamine supplementation in certain disease states has been extensively studied during the past decade, with use of both animals and human subjects. This article will review glutamine supplementation and its implications for WOC nursing practice.

ISSN:1071-5754    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

PurposeA descriptive study was conducted to investigate the sensitivity and specificity of the Braden Scale for Predicting Pressure Ulcer Risk in a cardiac surgical population.Patients and SettingA convenience sample of 337 pressure ulcer-free patients under-going cardiothoracic surgery at a large midwestern national referral center were enrolled in the study.MethodsSystematic skin and Braden Scale assessments were completed independently on the day of surgery and on postoperative days 1, 3, and 5. The presence of a pressure ulcer was determined and classified using the 4-stage scale developed by the WOCN Society.ResultsSixteen patients (4.7%) developed a total of 22 pressure ulcers. Sensitivity and specificity of Braden scores were calculated for the day of surgery and for postoperative days 1, 3, and 5. The established Braden “cutoff” score of ≤16 to identify those “at risk” had poor specificity and sensitivity in this patient population. The appropriate cut-off score varied by hospital day. A preoperative Braden score of 22 correctly classified 50% of the pressure ulcer-positive patients. The appropriate cutoff scores on postoperative day 1, 3, and 5 were 13, 14, and 20, respectively. Those scores correctly classified 67% of the pressure ulcer-positive patients on postoperative day 1, 57% on postoperative day 3, and 50% on postoperative day 5.ConclusionThese results illustrate that optimum prediction of pressure ulcer risk can only be accomplished with reassessments and determination of the Braden cutoff score or scores that are reflective of the patient's changing clinical condition throughout the hospitalization.

ISSN:1071-5754    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Although the evolution of clinical nurse specialists and nurse practitioners during the previous several decades has led to a sense of novelty regarding advanced practice, it is important to remember that nurses have engaged in such roles for nearly 100 years. This article will review the history of advanced nursing practice, summarize current definitions of specialty and advanced practice, discuss the evolution of advanced practice and its impact on contemporary nursing, and provide a background for advanced practice considerations for the WOC nurse, which are discussed in detail in subsequent articles by Janice Beitz (pp 55–64) and Dorothy Doughty (pp 65–8) in this issue.

ISSN:1071-5754    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Interest in clarification of the role of the WOC nurse as a specialized or advanced practice practitioner is increasing. Although much has occurred to delineate practice parameters, lack of expectations for specialty versus advanced nursing practice still exists. This article will differentiate advanced, specialty, and WOC nursing practice by examining their legal definitions, educational requirements, licensure, certifications, and practice milieus. Implications for the future of WOC nursing are posed within the context of the evolving American health care system.

ISSN:1071-5754    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The increased use of advanced practice nurses (APNs) in all health care settings provides new practice options for WOC nurses and new challenges for WOC nursing education. A number of WOC nurses are moving into APN roles, and APNs who are not WOC specialists are providing much of the primary care for patients with wounds, ostomies, and incontinence. New educational approaches are needed to prepare APNs for specialty practice in wound, ostomy, and/or continence care. In addition, the need exists to incorporate key WOC nursing content into the core curriculum for APNs who provide primary care for patients with or at risk for wounds or disordered elimination. This article explores potential strategies for meeting these new demands.

ISSN:1071-5754    

出版商:OVID    

年代:2000

数据来源: OVID