Journal of clinical nursing
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Sedation which is used for intubated patients may prolong mechanical ventilation by increasing the risk of complications. The aim of the study was to illuminate the specific terminology and unrecognized contextual factors which may influence nurses' and physicians' sedation practices. The main research questions were: How do nurses and physicians describe sedation? and How does the level of nursing skill relate to the level of sedation? The hypotheses were that sedation practices are inconsistent and that experienced nurses provide a better quality of sedation than less experienced nurses. ⋯ Sedative therapy was prescribed by physicians and administered by nurses. The four sites in the study did not use guidelines for sedation and did not use sedation level assessment tools. The study shows that when the terminology is unclear, the indications, interventions and outcomes become unclear.
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Nurse education does not appear to be preparing nurses to manage pain in the clinical area. A number of studies have demonstrated that nurses continue to have educational deficits in this context. ⋯ It is possible that innovative teaching strategies need to be used. The literature in this area is reviewed and recommendations made.
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Clinical Trial Controlled Clinical Trial
Effects of normal saline on endotracheal suctioning.
This study was designed to determine the effects of saline solution administered prior to endotracheal suctioning by nurses working in intensive care on oxygenation, heart rate and long-term pulmonary hygiene. The study was carried out on an experimental basis in the Intensive Care Unit of a university hospital in Turkey. A total of 20 patients were included, who were mechanically ventilated because of pulmonary or cardiovascular problems or trauma. ⋯ Patients undergoing suctioning with saline solution exhibited significantly increased heart rates in the fourth and fifth minutes, whereas no increases were detected in these undergoing suctioning without saline solution. SpO2 values obtained by pulse oxymeter did not show significant differences. Saline solution administered with suctioning resulted in undesirable, although not significant, alterations in oxygen saturation and arterial blood gas levels.
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Pain assessment and management are complex issues that embrace physiological, emotional, cognitive, and social dimensions. This observational study sought to investigate nurse-patient interactions associated with pain assessment and management in hospitalized postsurgical patients in clinical practice settings. Twelve field observations were carried out on Registered Nurses' activities relating to pain with their assigned patients. ⋯ These findings provide some understanding of the complexities impacting on nurses' assessment and management of postoperative pain. Further research using this observational methodology is indicated to examine these influences in more depth. This knowledge may form the basis for developing and evaluating strategic intervention programmes that analyse nurses' management of postoperative pain and, in particular, their administration of opioid analgesics.
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Previous studies have shown that nursing documentation is often deficient in its recording of pain assessment and treatment. In Sweden, documentation of the care process, including assessment, is a legal obligation. The aim of this study was to describe nursing documentation of postoperative pain management and nurses' perceptions of the records in relation to current regulations and guidelines. ⋯ Pain location was documented in 50% of the records and pain character in 12%. About 73% of the nurses reported that the documentation concurred with current regulations and guidelines. The findings indicate that significant flaws existed in nurses' recording of postoperative pain management, of which the nurses were not aware.