The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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Review Comparative Study
Does preoperative scalp shaving result in fewer postoperative wound infections when compared with no scalp shaving? A systematic review.
Preoperative scalp shaving has been a well-established practice among neurosurgeons based on the belief that hair removal prevents postoperative infections. Apart from aiding in improved visualization of the incision line, ease of closure, and dressing application, there are concerns that the presence of hair at the surgical site may interfere with the surgical procedure. Preoperative scalp shaving is a controversial practice, and many neurosurgeons are moving toward not removing any hair or clipping minimal hair along the incision line rather than shaving the scalp. ⋯ An evidence table was compiled to organize the study data and identify key points. The review brings strong evidence that preoperative scalp shaving does not confer any benefit against postoperative wound infection and, paradoxically, may lead to higher rates of infection. Because hair removal neither contributes benefits to the surgery itself nor decreases the risk of wound infection but has considerable cosmetic value for the patient, many of the authors recommended that cranial surgeries should be done without hair shaving.
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Randomized Controlled Trial Comparative Study
Effects of a standard versus comprehensive oral care protocol among intubated neuroscience ICU patients: results of a randomized controlled trial.
The purpose of the study was to compare changes in oral health during intubation until 48 hours after extubation in neuroscience intensive care unit (ICU) patients enrolled in a standard or a comprehensive oral care protocol. The effects of manual toothbrushing (standard group, n = 31) were compared with those of tongue scraping, electric toothbrushing, and moisturizing (comprehensive group, n = 25) in intubated patients in a neuroscience ICU in a 2-year randomized clinical trial. Oral health was evaluated based on the Oral Assessment Guide (OAG) on enrollment, the day of extubation, and 48 hours after extubation. ⋯ In four categories, the ratings on tongue, mucous membranes, gingiva, and teeth did not deteriorate significantly over time. Published oral care protocols are substandard in promoting and maintaining oral health in intubated patients. A comprehensive oral care protocol, using a tongue scraper, an electrical toothbrush, and pharmacological moisturizers, was more effective for oral hygiene throughout intubation and after extubation than manual toothbrushing alone.
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The purpose of this secondary analysis was to investigate the relationships among a set of symptoms (fatigue, depression, impaired cognitive function, sleep disturbance) with pain severity and demographic variables. The sample of 40 women with relapsing-remitting multiple sclerosis completed instruments of pain, fatigue, depression, sleep disturbance, and an objective cognitive measure. ⋯ Pain severity correlated with fatigue, sleep disturbance, depression, and impaired cognitive function. Preliminary findings support providing education on symptoms to women with relapsing-remitting multiple sclerosis to ultimately guide their care.
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This study was performed to assess disability on daily living activities, which developed secondary to low back pain, in patients with lumbar disc herniation and treated either conservatively or surgically. The study was performed between November 2008 and June 2009. Visual analogue scale (VAS) was used to measure the intensity of pain, and the Oswestry Disability Index (ODI) was used to assess the disability of the patients on daily living activities. ⋯ Their daily living activities are affected by these disabilities and the intensity of pain affects the level of disability. Knowledge of the disability areas caused by low back pain plays an important role in the determination of nursing care and content of the education which will be offered to the patients. The use of scale on the patient's care is important to form a common language in nursing and to obtain evidence-based data related to the patients.
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Pediatric severe traumatic brain injury treatment guidelines for nutrition indicate that "there are insufficient data to support a treatment guideline for this topic" (P. D. Adelson et al., 2003). ⋯ Median ICU LOS was 2.1 days (0.01-97.9 days). Overall, 48% of patients were discharged home; 28% experienced mild, moderate, or severe disability; and 24% either died or survived in a vegetative state. Early initiation and achieving full caloric intake were both positively correlated with shorter LOS in the ICU (p < .01, Spearman's rho correlational matrix) and better disposition status at discharge from the hospital (p < .05, Kruskal-Wallis test).