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

ISSN:1071-5754    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Panniculectomy surgery is a reconstructive procedure performed to remove a panniculus, sometimes referred to as a pannus or abdominal apron. The pannus frequently contributes to a number of health concerns, including chronic wounds. Panniculectomy surgery becomes necessary for many patients who have had massive weight loss as a result of successful bariatric weight-loss surgery. Bariatric weight-loss surgery is one of the fastest growing specialties in America, and therefore, nurses can expect to care for increasing numbers of patients who require this reconstructive procedure. Despite the medical necessity of panniculectomy surgery, barriers to reimbursement exist. An update on the demographics of obesity, nationally and worldwide, are presented, especially as this information relates to the growing interest in panniculectomy surgery following massive weight loss. Bariatric weight-loss surgery and panniculectomy surgery are described and barriers to reimbursement are explained. The importance of wound care documentation in making the case for reimbursement is described, and a sample letter of appeal is provided.

ISSN:1071-5754    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Hospitalization of the morbidly obese patient is a challenging experience for both the patient and his or her caregivers. Risk of skin breakdown is increased due to immobility caused by underlying disease processes, sedation, improperly sized rooms and equipment, and inadequate staff numbers or staff who lack training in bariatrics. Many of the common and predictable complications related to obesity are more closely related to the nurse's inability to mobilize the patient because of improperly sized rooms and equipment. To complicate matters, wound healing may be impaired by obesity-related underlying disease, such as diminished tissue perfusion. These risks exist in all areas of patient care, including the operating room, emergency department, and nursing units. In this article the demographics, definition, and etiologies of obesity, along with skin breakdown, are described, and the prevention of skin breakdown in hospitalized morbidly obese patients is explored.

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:

Compromised urinary bladder syndrome (CUBS) is defined as urinary frequency (UF) and/or urinary incontinence (UI) sufficient to be a problem. This term is an expansion of separate mainstream concepts referring to UF and UI, because the new term entails both phenomena considered at one time. Cognitive strategies (CS) offer one way to enhance the effectiveness and implementation of behavioral interventions directed to assist persons with CUBS. Two hypotheses predicted that persons receiving bladder health information would show less improvement on the outcomes than those receiving CS only or those receiving CS plus coaching after adjusting for type of UI. Secondly, persons receiving CS only would show less improvement on the outcomes than those receiving CS plus coaching. Data were collected at 3 time points, and the outcomes measured were comfort, bladder function, incidents of UF/UI (as recorded by participants in a diary), and perception of health. Neither hypothesis was fully supported. However, persons receiving information and information with CS plus coaching improved on comfort and UI/UF; all groups increased on bladder function; and perception of health did not change in any of the groups. Explanations for the mixed findings are proposed. In general, these findings support the application of conservative, noninvasive cognitive interventions innovatively applied through the use of pamphlets and audiotapes to help persons with CUBS experience increased comfort and improved bladder function. Implications for clinical practice are to provide a two-tiered intervention: education followed by CS with coaching if needed to enhance bladder function. A nursing role (as coaching) to augment specific interventions for CUBS is supported and should be differentiated for persons with symptoms of urgency.

ISSN:1071-5754    

出版商:OVID    

年代:2003

数据来源: OVID