Applied nursing research : ANR
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This article examines acute pain management practices for patients 65 years of age and older who were hospitalized during 1999 for hip fracture. Data were collected from the medical records of patients (N = 709) admitted to 12 hospitals in the Midwest and from questionnaires on pain practices completed by nurses (N = 172) caring for these patients. The major variables examined were (1). pharmacological and nonpharmacological treatments for acute pain in hospitalized elders, (2). nurses' perceived stage of adoption for avoiding meperidine use and for administering analgesics around-the-clock, and (3). nurses' perceived barriers to optimal treatment of acute pain in elders. ⋯ The most frequently used nonpharmacological intervention was repositioning, followed by use of pressure relief devices and cold application. Nurses reported difficulty contacting physicians and difficulty communicating with them about type and/or dose of analgesics as the greatest barriers to pain management. Findings from this multi-site study show that active and focused "translation" interventions are needed to promote adoption of evidence-based acute pain management practices by health care providers.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of acupressure bands and droperidol for reducing post-operative nausea and vomiting in gynecologic surgery patients.
The purpose of this study was to evaluate the effectiveness of acupressure bands, droperidol, and the combined modalities, administered preoperatively, in reducing PONV in inpatient gynecologic patients. One hundred and forty-three patients were randomized to one of four groups: droperidol and acupressure bands, droperidol and placebo bands, placebo drug and acupressure bands, or placebo drug and placebo bands. Overall, during their hospital stay, 69% of the women experienced PONV and 45% experienced vomiting at some time. Although droperidol was most effective the day of surgery, neither acupressure bands or droperidol were effective in reducing PONV.
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This prospective study investigated risk factors for delirium in elderly hip fracture patients that could be recognized by nurses. Data were collected on predisposing and precipitating factors for delirium from 92 elderly patients with a hip fracture. Predisposing factors included age, gender, sensory impairments, functional impairment before the hip fracture, residency before admission, pre-existing cognitive impairment, comorbidities, and medication use. ⋯ Based on these findings, it is recommended that nurses should assess patients' pre-fracture functional and cognitive capacities in an early stage of the hospital stay. Nurses should also be alert to postoperative delirium in "healthy elderly" patients. Monitoring of symptoms postoperatively in all elderly patients is advised.
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Intensive care unit nurses were asked how they prepared families for the death of their patient following withdrawal of mechanical ventilation. Forty-three descriptors were identified, of which 67.5% (n = 29) were "physical sensations and symptoms." Less frequently mentioned features of Self-Regulation Theory were temporal characteristics, environmental features, and causes of these signs. Eight descriptors mentioned by more than 50% of nurses were skin color changes (74%), skin temperature changes (74%), varying levels of consciousness (74%), effort with breathing (71%), variable timeframe to death (68%), breathing pattern (65%), sound during breathing (61%), and loss of bowel control/incontinence (52%).
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Comparative Study Clinical Trial
Comparison of intravenous cannulation injectable preanesthetics in an adult medical inpatient population.
Prior intravenous cannulation (IVC) injectable preanesthetic research has focused primarily on the presurgical population. This focus may diminish the applicability of these findings to the rest of the adult inpatient population. ⋯ This study is the first to examine the adult medical inpatient pain response associated with peripheral IVC for patients receiving subcutaneous buffered lidocaine 1%, subcutaneous normal saline 0.9% with the preservative benzyl alcohol, or no treatment. Further investigation is needed to build on the previous and current research to enhance a clinicians ability to provide individualized IVC preanesthetic treatment options.