The Nursing clinics of North America
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Nurs. Clin. North Am. · Mar 1995
Contracted visiting hours in the coronary care unit. A patient-centered quality improvement project.
As critical care technology advances, the need to provide patient-centered care becomes increasingly critical. Grandstrom states that patients and families want "more." They have greater expectations and demand greater knowledge and involvement, vis-à-vis the hospital experience. Rather than indicating a desire to observe procedures or equipment, these expectations reveal a more personal and human need--the desire of patients and families to maintain contact and interact with one another. ⋯ It is believed that implementation of flexible visiting hours has increased the staff's awareness of the patient and family as consumers. In today's competitive health care environment, Artinian proposes that "strengthening relationships with families may make the critical difference related to patients' and families' choices about whether a health-care setting meets their needs." By implementing flexible visiting hours these relationships are enhanced and consumer satisfaction is influenced. Also, the institutional goal of patient-centered care, and ultimately quality patient care, is promoted.
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A thorough understanding of the incidence, clinical presentation, treatment, prognosis, and psychosocial issues surrounding children with solid tumors enables the nurse to actively participate on the health care team. Although significant advances over the past two-and-a-half decades to improve the outcomes of children with cancer have occurred, there remains room for continued improvement, especially among children with advanced-stage nephroblastoma, neuroblastoma, HCC, and teratoma.
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This article discusses methods of reconstruction, ranging from simple free-hand skin grafts to microvascular tissue transfer. The simplest reconstructive option must be chosen to suit the defect and to achieve the least possible donor morbidity. The most suitable reconstructive choices are discussed for each of the following situations: to provide a large surface area, to provide hair-bearing tissue, to fill "dead space," to restore motor function, or to provide composite bone and soft-tissue structures.
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Nurs. Clin. North Am. · Sep 1994
ReviewHigh-technology in home care. An overview of intravenous therapy.
The administration of i.v. medications in the home environment has proven to be a viable and highly desirable alternative to traditional hospitalization. Technology has been the driving force behind the safe transition of the more acutely ill patient from the hospital to the home. ⋯ Home infusion therapy allows for the integrity of the family to remain intact and provides the option for greater participation by the patient and caregiver in the development and implementation of the treatment plan. Most important, technology has led to the evolution of home infusion therapy as a high-quality, cost effective approach to care in a troubled health delivery system.
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Intraspinal drug delivery is one of several important pain management therapies. Numerous delivery methods and drugs are available for administration into the epidural or intrathecal space. ⋯ Nurses can assist in this screening and perform preoperative teaching, postoperative care, and long-term follow-up. Essential knowledge includes general pain management principles as well as principles of intraspinal drug delivery.