Journal of clinical nursing
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Previous research in a retrospective community-based study suggested that some relatives had difficulty coping with their bereavement when the pre-bereavement period had not been managed well. This prospective study in a hospital setting explored the issues further to include the views and needs of staff as well as relatives. ⋯ Findings demonstrated that staff often felt ill-equipped for providing support for relatives when a patient is dying. Training is required to help nurses support and care for the relatives of dying patients.
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This paper reviews the literature related to the Intensive Care Unit (ICU) Syndrome. The intention of the paper is to explore the range of psychotic and affective phenomena that may be observed in practice, together with the management of contributory stressors. Patients experience a range of psycho-affective disturbances that may be triggered by drugs, the environment, dehumanizing practices and sleep deprivation. ⋯ Comprehensive assessment of the patient's psychological state, using an appropriate tool, is necessary and should form an integral part of ongoing care. Interventions identified include eradication of dehumanizing behaviour, modification of environmental stimuli, effective communication and therapeutic touch. Where possible, communication needs should be addressed prior to admission, and patients and their families prepared for the unfamiliar world of the ICU.
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Randomized Controlled Trial Clinical Trial
An experimental study on the use of manual pressure to reduce pain in intramuscular injections.
To investigate whether the application of manual pressure to the injection site before intramuscular injection reduces pain. An experimental study with intrasubject comparison was conducted using manual pressure to reduce pain associated with intramuscular injection. Seventy-four subjects, participating in an immunization vaccination campaign, were recruited by convenience sampling from a university. ⋯ Results demonstrated a significant difference in the perceived pain intensity for experimental and control conditions. Subjects with manual pressure applied before injections reported lower pain intensity scores, whilst those without the application of manual pressure before injections reported higher pain intensity scores. Applying manual pressure to an injection site before performing an injection could be an effective means of decreasing pain intensity.
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1. In this cost-conscious climate there is a need to make explicit and justify the rationale to support direct patient contact by Registered Nurses. The current shortage of qualified nursing staff means that it is essential that experience and expertise be utilized to the benefit of patients and the service as a whole. 2. ⋯ The results demonstrate that nurses working in this general intensive care unit spent 85% of their time in activities associated with providing direct patient care. However, up to 6% of time was spent undertaking non-nursing duties, and analysis of unit activity provided data to support an increase in the establishment and review of the shift patterns of health care assistants. 5. The findings of the study indicate that nurses in charge of shifts spend 24.1% of their time in managerial and administrative activity; this reduces the amount of time spent in direct patient contact.
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1. The nursing handover is a key activity for nurses working in acute hospital wards in the NHS. Little scholarly attention has been paid to the use nurses make of the information exchanged during nursing handover or how certain features of the nursing handover might impact positively or negatively on patient outcomes. 2. ⋯ The second was as a source of information on which to base their nursing decisions and actions. 5. It is proposed that some qualified nurses need help with the emotional labour of caring for dying people and that the nursing handover can assist in emotional adaptation, so enabling the management of troubling thoughts or feelings experienced in the course of caring for someone who is dying. 6. The role of the nursing handover in providing emotional support for nurses has been little studied and is a potentially useful area of future research, especially if it can be related to patient experiences and outcomes.