Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society
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J Wound Ostomy Continence Nurs · Jan 2009
Nursing interventions to reduce the risk of catheter-associated urinary tract infection. Part 1: Catheter selection.
The urinary system is the most common site for all hospital-acquired infections, accounting for approximately 40% of all nosocomial infections. The US Centers for Medicare & Medicaid Services has enacted 2 policies that have focused considerable attention on the optimal use of indwelling catheters in the acute and long-term care settings and the prevention of complications including catheter-associated urinary tract infection (CAUTI). ⋯ Insertion of an antimicrobial catheter, either silver alloy or antimicrobial coated, is recommended for patients with short-term indwelling catheterization. There is insufficient evidence to recommend their use in patients managed by long-term indwelling catheterization. Selection of smaller French sizes for short- or long-term catheterization is thought to improve comfort and reduce CAUTI risk, but further research is needed to substantiate these best practice recommendations.
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J Wound Ostomy Continence Nurs · Jan 2009
Honey-based dressings and wound care: an option for care in the United States.
Honey-based wound dressings have been used worldwide since ancient times. A honey product received US Federal Drug Administration approval in 2007, making this dressing an option for wound care. Honey has been found to exert anti-inflammatory and antibacterial effects without antibiotic resistance, promote moist wound healing, and facilitate debridement. ⋯ As is true of any wound dressing, its use must be carefully selected and monitored. Continued research is needed to add to its evidence base. This article provides a summary of the current evidence base for the use of honey and a review of its therapeutic effects and discusses implications for WOC nursing practice.
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J Wound Ostomy Continence Nurs · Sep 2008
Comparative StudyComparison of recall and daily self-report of fecal incontinence severity.
Fecal incontinence (FI) severity is determined by self-report, and most tools rely on recall of symptoms. This study examined whether recall of FI severity differed from daily reports on a diary and the factors influencing any difference. INSTRUMENTS AND DESIGN: Data of 96 participants (mean age 59 years, 78% female) reported on 3 data collection forms (a demographics form, a bowel history, and a stool diary) were analyzed. Data collected during an initial bowel history when participants reported FI severity using recall were compared to similar data participants recorded on a 14-day daily stool diary during a baseline period of a study investigating the effects of different types of dietary fiber on FI. ⋯ Reasons for underreporting FI are probably multifactorial; findings suggest that being a caregiver and having double incontinence are contributing factors. Clinicians should inquire about FI with a discerning yet sensitive approach. Use of a daily stool diary is recommended in research and may be useful in practice.
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J Wound Ostomy Continence Nurs · Jul 2008
Impact of tight glucose control on postoperative infection rates and wound healing in cardiac surgery patients.
Approximately 1 of every 4 hospitalized patients has diabetes mellitus (DM). Type 2 DM is commonly associated with cardiovascular disease, and many undergo cardiothoracic surgical procedures such as coronary artery bypass grafting. Persons with type 2 DM are at higher risk for postoperative infections due to a muted immune response, the effects of hyperglycemia on neutrophil function and pathogen proliferation, and the negative effects of diminished perfusion. ⋯ Tight glucose control has been shown to improve survival and reduce morbidity after cardiac surgery and lower the incidence of wound complications. In contrast, the traditional approach to glucose management, sliding-scale insulin administration, does not provide adequate control. Continuous insulin infusion protocols may significantly reduce postoperative morbidity and mortality in patients with type 2 DM and hyperglycemia associated with metabolic syndrome.
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J Wound Ostomy Continence Nurs · May 2008
ReviewSystematic reviews and meta-analysis: studies of studies.
Systematic reviews are designed to answer a focused clinical question. They employ a predetermined explicit methodology to comprehensively search for, select, appraise, and analyze studies. ⋯ High-quality systematic reviews can be powerful tools to support clinical decision-making, as well as summarize current knowledge in relation to an area of research interest. This article describes the methodology that should be used when doing a systematic review, presents guidelines for reporting the review, and provides a guideline for critically appraising published reviews.