Orthopaedic nursing
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Orthopaedic nursing · Jan 2008
Comparative StudyComparison of self-reported pain and the PAINAD scale in hospitalized cognitively impaired and intact older adults after hip fracture surgery.
The purpose of this study was a psychometric evaluation of the PAINAD to assess pain in hospitalized cognitively impaired and intact older adults admitted for surgical repair of a hip fracture. ⋯ A positive correlation was found between the PAINAD and a self-report pain scale, providing evidence of concurrent validity. PAINAD scores were higher when patients were likely to experience pain than when unlikely, providing evidence of discriminant validity. The results of this study provide evidence supporting the validity and reliability of the PAINAD in the pain assessment of hospitalized post-orthopaedic surgical older adults who are unable or reluctant to self-report pain.
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Orthopaedic nursing · Nov 2007
Comparative StudyPostoperative benefits of intrathecal injection for patients undergoing total knee arthroplasty.
The purpose of the study was to compare postoperative outcomes in patients undergoing total knee replacement via general anesthesia with patients receiving an intrathecal injection for anesthesia. ⋯ The use of an intrathecal injection for pain management changes postoperative nursing care planning and interventions. Improved pain control results in more alert and responsive patients and earlier ambulation. Patient teaching for prevention of complications and self-care postdischarge can begin earlier.
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Published incidence of delirium in orthopaedic patients ranges from 5.1% to 61%. Delirium may present before or after the patient undergoes the surgical procedure and has demonstrated increased risk, including mortality. Yet, delirium goes unrecognized by both physicians and nurses. This article focuses on the literature on delirium in the orthopaedic patient, including incidence, how to identify those patients at risk, patient outcomes, nonpharmacological and pharmacological interventions, and provides an example of how one tertiary care hospital implemented a prevention and management program of delirium in orthopaedic patients.
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Orthopaedic nursing · Mar 2007
DepoDur extended-release epidural morphine: reshaping postoperative care. What perioperative nurses need to know.
Epidural morphine as a single bolus dose has demonstrated analgesia that lasts up to 24 hours. Recent advances in drug delivery mechanisms have resulted in a formulation of morphine, DepoDur, which is a lipid-encapsulated extended-release epidural morphine that provides up to 48 hours of analgesia. ⋯ The unique characteristics of DepoDur dictate that clinicians must be aware of the benefits and risks, and facilities must have a comprehensive system to allow for the safe administration of DepoDur. This article provides information on this novel drug delivery system, reviews research findings reported in the literature, and describes the relational collaboration system designed and implemented at Duke University Health System for safe patient care of DepoDur recipients.