The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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Randomized Controlled Trial
Oral care intervention to reduce incidence of ventilator-associated pneumonia in the neurologic intensive care unit.
Ventilator-associated pneumonia (VAP) is a preventable secondary consequence of intubation and mechanical ventilation. VAP is pneumonia that develops in an intubated patient after 48 hours or more of mechanical ventilator support. Mechanically ventilated patients in neurologic and other intensive care units (ICUs) are at an increased risk of VAP due to factors such as decreased level of consciousness; dry, open mouth; and microaspiration of secretions. ⋯ Patients were randomized into a control group that performed usual oral care or an intervention group that brushed teeth every 8 hours. The results were immediate and startling, as the VAP rate dropped to zero within a week of beginning the every-8-hours toothbrushing regimen in the intervention group. The study was so successful that the control group was dropped after 6 months, and all intubated patients' teeth were brushed every 8 hours, maintaining the zero rate until the end of the study.
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Deep brain stimulators (DBS) may be affected by electromagnetic interference (EMI). Little research has been conducted regarding this phenomenon, although supportive background information and a literature review offer implications of EMI for persons who have this device. The warning information on Medtronic's Web site that is specific to the DBS device indicates that theft detectors and security screening devices may cause the stimulation to turn on or off and may cause some patients to experience a momentary increase in perceived stimulation. ⋯ EMI with DBS does not appear to present an immediate safety issue even though it may cause device malfunction and a resulting temporary interruption in therapeutic benefit for persons who have the device. However, the absence of sound research on the effects of EMI on DBS does not permit the exclusion of EMI as a potential health concern. Meanwhile, healthcare professionals who care for patients with DBS should routinely educate them about potential interactions and appropriate accommodations.
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The well-being of patients' next of kin can be an important factor with regard to the care and rehabilitation of patients with multiple sclerosis (MS). The aim of this qualitative study was to explore the presence and meaning of chronic sorrow in a group of next of kin of patients with MS. ⋯ Three main themes characterized the meaning of chronic sorrow: loss of security, loss of sense of community in family life, and loss of joy and recreation. This study indicates that nurses need to devote greater attention to the well-being of next of kin, offering support programs to help them cope with chronic sorrow.