Heart & lung : the journal of critical care
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The objective of this study was to investigate body weight change in adult patients undergoing cardiac surgery and to assess the accuracy of conventional recorded fluid balance charting methods to reflect this change in body weight. ⋯ Body weight in patients who undergo cardiac surgery was found to fluctuate over the perioperative period. Use of recorded fluid balance to reflect change in body weight for patients undergoing cardiac surgery was deemed unreliable. Further investigation of body weight change and scrutiny of conventional recorded fluid balance charting methods for patients who undergo cardiac surgery is needed.
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Comparative Study
Dyspnea self-management strategies: use and effectiveness as reported by patients with chronic obstructive pulmonary disease.
The purposes of this study were to (1) identify the frequency with which patients with chronic obstructive pulmonary disease (COPD) use dyspnea self-management strategies and (2) quantitatively describe the patients' perceptions of self-management strategy effectiveness. ⋯ This study presents a beginning understanding of the perceptions of dyspnea self-management strategy effectiveness and frequency of strategy use in patients with COPD. The study also emphasizes the need for clinicians to individualize self-management strategy recommendations.
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Comparative Study
Overuse of prothrombin and partial thromboplastin coagulation tests in medical inpatients.
In the monitoring of anticoagulant therapy, prothrombin time (PT) is used to measure the effect of warfarin, whereas the partial thromboplastin time (PTT) measures the therapeutic effect of unfractionated heparin. Low molecular weight heparin (LMWH) does not require routine monitoring. ⋯ The review of the records of 50 medical inpatients found that PT and PTT were invariably requested together, despite a lack of indication. The 50 patients incurred a total of $2434 in unneeded costs. If representative of common clinical practice, significant cost savings may be possible. Education, computerization, and information on costs of individual tests may reduce unneeded investigations.
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The purpose of this study was to examine the role of the nurse with families of critically ill patients as perceived by family members and whether meeting family expectations impact family satisfaction. ⋯ Nurses did well with regard to meeting family members' expectations. Variations in expectations among family members reflect their diversity and highlight the importance of assessing family needs on a case-by-case basis.
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Inserting an intravenous catheter (IV) is one of the most frequently performed invasive procedures by nurses. Little research has been conducted on ways to reduce the difficulty and failure, and enhance the ease and success, of IV insertion. We conducted this study to determine variables associated with IV insertion difficulty, failure, and success, and to learn special techniques nurses use to facilitate IV insertion. ⋯ Approximately one fourth of the 339 IV insertions in this study were unsuccessful. Repeated insertion attempts are painful and costly. This study identified nurse, patient, and IV variables associated with IV insertion success and failure. Future research is needed to confirm and expand these findings and to develop interventions to improve IV insertion skills and outcomes.