The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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Falls among hospitalized patients are common occurrences and can have detrimental effects on patient outcomes. Identifying high-risk patients and taking measures to prevent patient falls have been successful. The purpose of this project was to decrease the fall rate in adult neuroscience patients. ⋯ Risk factors were identified through the use of the patient's history, nursing data base and patient classification system. Patients with identified risk factors were placed on fall precautions which included interventions specifically designed to prevent patient falls. This project resulted in a decrease in the number of patient falls and increased staff awareness of the risk factors associated with falls among adult neuroscience patients.
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Instruments developed for use in any clinical setting must be tested for validity and reliability. The interrater reliability of neuroscience nurses' assessments for motor power using the Sunnybrook Health Science Centre Spinal Cord Testing record was determined using eleven patients with spinal cord lesions. Percentage of agreement between raters exceeded the predetermined acceptable level of 80%, and Kappa coefficient of agreement indicated excellent interrater agreement (K = .90, p less than .001). Study limitations are identified, and indications for further research discussed.
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The use of epidural narcotics is fast becoming an accepted technique for postoperative pain relief. Reduction of the patient's narcotic requirements, increased movement in bed and cooperation with postoperative exercises are the major advantages of this type of therapy for pain relief. ⋯ Nurses should also be knowledgeable about the technical aspects of the procedure for catheter insertion and the narcotics that might be used for postoperative pain relief. Nursing implications for patients receiving epidural narcotics for postoperative pain relief are presented.
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Since the introduction of propranolol in the 1970s, beta adrenergic antagonists have been used widely for cardiac and noncardiac disorders. The recent introduction of esmolol offers many advantages over other beta blockers. Included among them are rapid onset and elimination and beta selectivity. It has wide application in acute care settings.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of three methods of managing fever in the neurologic patient.
Patients with neurological dysfunction can suffer fevers due to irritation of, or damage to the temperature-regulating center in the brain, or a combination of both. Although hypothermic therapy is a critical treatment nurses often perform, the most effective cooling method has not been studied in the neurological patient. The purpose of this quasi-experimental study was to compare the effectiveness of three methods of fever reduction, and the effect of each on patient shivering. ⋯ The mean time necessary for the subject's temperature to return to 100 degrees F was calculated. A one-way analysis of variance of the time required to reach 100 degrees F was done to determine if a significant difference existed in rate of temperature reduction among the groups. The analysis revealed no statistically significant difference among the three methods, but a chi-square analysis indicated a significant relationship between shivering and the use of a hypothermia blanket.