Journal of advanced nursing
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This paper presents a concept analysis of suboptimal care of the acutely unwell ward patient. ⋯ For future research, investigators need to develop more objective measures which capture delays in the treatment and inappropriate or inadequate management of acutely unwell patients. This should occur through critical focus on the antecedents to suboptimal care.
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This paper reports on a study of the experiences of general practitioners and practice nurses implementing nurse-delivered cardiovascular prevention to high risk patients in primary care. ⋯ Both general practitioners and practice nurses were positive about nurse-delivered cardiovascular prevention in primary care. Nurses could play an important role in successive removal of barriers to implementation of cardiovascular prevention. Mutual confidence between care providers in the healthcare team is necessary.
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The aim of this study was to measure the degree of similarity of attitudes on collaboration between nurses and junior doctors (known as residents in the United States) in the ICU. ⋯ Nurses and junior doctors held very different views on the amount of collaborative teamwork that occurs in the ICU. Junior doctors' views are similar to those of more experienced physicians observed in previous studies.
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This paper is a report of a scoping review of research on cognitive impairment in older adults who visit Emergency Departments of acute care hospitals, followed by an integrative review that included a quality assessment to determine the effectiveness of interventions for this population. ⋯ Although the prevalence and incidence of cognitive impairment is recognized, appropriate interventions and programmatic responses remain elusive. Quality improvements require more thorough examination of emergency department context to identify modifiable influencing factors that are transferable across settings.
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Comparative Study
Comparative evaluation of five needleless intravenous connectors.
The purpose of this study was to evaluate in vitro differences of colony forming units (CFUs), of four different bacteria (Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli), over 4 days, using bovine blood, in five intravenous needleless connectors (three negative, one positive, one zero). ⋯ Non-antimicrobial connectors differ on colony forming unit counts in vitro for four types of bacteria. Connectors with most colony forming units to least colony forming units included the Q-Syte™, TKO™Clave(®), MicroCLAVE(®), MaxPlus(®) Clear and RyMed-5001(®). Connectors are one statistically significant variable (50%) in the development of occlusions and infections. Staff nurses, managers, infection control specialists and vascular access specialists in all settings need to use technologies that invoke the least patient harm. The RyMed-5001(®) connector best protects the intraluminal pathway from bacteria compared with four other commonly used connectors in vitro.