ISSN:1071-5754    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveThe objective of this study was to explore the approach taken by nurses in an adult acute-care hospital to the assessment and management of people with urinary incontinence.DesignA qualitative exploratory and descriptive design was used.Setting and subjectsThirty-three registered nurses from medical and surgical areas of an adult acute-care hospital in Melbourne, Australia, were recruited to participate in the study.Instruments and methodsA questionnaire was developed using a series of 5 scenarios, each representing typical stories relating to different types of urinary incontinence. The participants' responses were analyzed for themes. The findings were presented in a focus group of participants to check validity of the findings and to discuss the implications for practice.ResultsThe researchers found that the participants in this study were limited in their assessment and management of people with urinary incontinence.ConclusionsThe results of this study suggest that acute care nurses have limited ability to assess and manage varying types of urinary incontinence. There are many possible reasons for this limited ability, primarily lack of knowledge, but contributing factors are lack of time, lack of support, and a culture that fails to promote independent practice and holistic care. Specific continence education in undergraduate nursing programs and following graduation is indicated, and acute-care hospitals need to develop systems, processes, policies, documentation, and role models to enhance the care of clients with urinary incontinence.

ISSN:1071-5754    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Literature related to urinary tract infection (UTI) in people with long-term use of urinary catheters was reviewed and analyzed to identify strengths and gaps in knowledge. Topics addressed includeddefinitions of UTI, epidemiology/risk factors, infection rates, pathophysiology, bodily defensemechanisms, and interventions. Surveillance of UTI for community-dwelling people with catheters is hampered by a lack of agreement on definitions of UTI and thus the basis for calculating UTI rates. Moreover, no agreement exists on what constitutes long-term use. Additional knowledge aboutspecific risk factors in this home care population could lead to interventions to prevent or minimize UTIs. Suggestions are made for standardizing definitions of UTI and for clarifying reports of UTI rates. Continence nurses are in a position to advance this area of research and practice.

ISSN:1071-5754    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveOur objective was to describe the spectrum and preferences of terminology used by house staff and attending physicians in internal medicine, general surgery, surgical subspecialties, physical medicine and rehabilitation, staff nurses, clinical nurse specialists, and others when documenting a skin ulcer examination on admission or at consultation.DesignThis study was a retrospective review of a purposeful sample of 75 charts.Setting and subjectsStudy subjects were physicians and nurses working in an urban teaching hospital.MethodsMethods used were abstraction from the medical record of the frequency with whichaspects of a skin ulcer examination were documented and qualitative analysis of the descriptive terminology.ResultsAs consultants, clinical nurse specialists for skin care and plastic surgeons were the most complete in documenting location, size, and the tissue characteristics of skin ulcers. Ninety percent of house staff and staff nurses of the primary team documented the existence and location of the ulcer. Some characteristic of the tissue was described by staff nurses and house staff for 80% and 78% of the ulcers, respectively. Quantitative size was the least frequently documented component by both nurses and house staff for 60% and 33% of the ulcers, respectively. A total of 66 unique terms including 38 nonmedical, nonspecific, or ambiguous terms were found.ConclusionsDocumentation of skin ulcers in the notes of physicians and nurses are incomplete and nonstandardized, and the terminology used does not allow an accurate retrospective conceptualization of the ulcer. The clinical implications are miscommunication between multidisciplinary teams, difficulty assessing healing rates, and inability to perform retrospective quality assurance reviews. Development of a standardized skin ulcer examination with a meaningful taxonomy of terms acceptable to physicians, nurses, and occupational and physical therapists is needed to teach interdisciplinary care of patients with skin ulcers.

ISSN:1071-5754    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Sixty-one percent of Americans are overweight, and 20% are considered obese. The number of obese adults has doubled since 1960, and the number of overweight teenagers has tripled. In many overweight people, skin and wound conditions develop over the abdominal area, largely because of the consequences related to a large abdominal apron or panniculus. Panniculectomy surgery is performed to remove a massive pannus, or abdominal apron, which frequently contributes to a number of health concerns and threatens quality of life. Some patients are candidates for surgical removal of the pannus, and some are not candidates for this surgery. Occasionally cellulitis develops over the panniculus, leading to panniculitis. Panniculitis can lead to skin and wound problems; likewise, skin injury can lead to panniculitis. Additionally, in obese patients who require general surgery in the abdominal area, skin and wound complications may develop simply as a result of having a large panniculus. In this article, local wound care and preoperative and postoperative nursing care are discussed and case studies are presented.

ISSN:1071-5754    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveThe aim of the study was to obtain knowledge about leg and foot ulcer care performed by nurses in community health care.DesignThis is a descriptive observational study.Setting and subjectsThe sample consisted of Norwegian home care nurses (n = 31), student nurses (n = 30), and patients with leg and foot ulcers (n = 32). Thirty-five ulcer treatments were observed in the patients' homes.MethodsA structured observation form with space for additional notes and assessments was used. Photographs were taken of the ulcers. Information on background variables for patients and nurses was collected, and descriptive and interpretive analyses were performed. Nursing students made the observations.ResultsIn 16 situations the patients had no ulcer diagnosis, and most of the patients (79.9%) had other serious chronic diseases. The home care nurses were uncertain about their assessment of the ulcers, and the treatment principles were not always current; for example, dry dressings and normal saline were used for cleansing. Twenty-eight different dressing combinations were used on the 35 ulcers. Compression was used on undiagnosed ulcers, sometimes incorrectly. Hand-washing routines were poor, and the treatment was often poorly documented. Poor working conditions were also observed, such as bad lighting in the room. The majority of the ulcer treatments lasted 20 to 30 minutes.ConclusionThe study identifies areas where leg and foot ulcer treatment by home care nurses can be improved with respect to technique and documentation.

ISSN:1071-5754    

出版商:OVID    

年代:2003

数据来源: OVID