The Permanente journal
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The Permanente journal · Jan 2016
Treatment of Alcohol Withdrawal Syndrome with and without Dexmedetomidine.
Studies suggest that dexmedetomidine-an intravenous central-acting α2-adrenergic agonist that effectively reduces anxiety among critically ill patients-is being used in patients with severe alcohol withdrawal. However, evidence supporting its use is limited, and it is not approved for this indication. ⋯ Dexmedetomidine initiation was associated with a reduction in short-term alcohol withdrawal symptoms in patients in the intensive care unit, with only a few patients experiencing adverse events. However, its use was also associated with longer hospitalizations. Further research is necessary to evaluate whether dexmedetomidine is efficacious or cost-effective in severe alcohol withdrawal.
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The Permanente journal · Jan 2016
Association of Unplanned Reintubation with Higher Mortality in Old, Frail Patients: A National Surgical Quality-Improvement Program Analysis.
Unplanned postoperative reintubation increases the risk of mortality, but associated factors are unclear. ⋯ Among patients who underwent unplanned reintubation, older and more frail patients had an increased risk of mortality.
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The Permanente journal · Jan 2016
Observational StudyRisk of Delayed Intracerebral Hemorrhage in Anticoagulated Patients after Minor Head Trauma: The Role of Repeat Cranial Computed Tomography.
Patients receiving anticoagulant medications who experience minor head injury are at increased risk of an intracerebral hemorrhage (ICH) developing, even after an initial computed tomography (CT) scan of the brain yields normal findings. Conflicting evidence exists regarding the frequency at which delayed bleeding occurs. ⋯ Trauma patients in the ED who are receiving warfarin or clopidogrel have approximately a 2.5% risk of delayed ICH after an initial normal finding on a head CT.
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The Permanente journal · Jan 2016
Future Challenges of Robotics and Artificial Intelligence in Nursing: What Can We Learn from Monsters in Popular Culture?
It is highly likely that artificial intelligence (AI) will be implemented in nursing robotics in various forms, both in medical and surgical robotic instruments, but also as different types of droids and humanoids, physical reinforcements, and also animal/pet robots. Exploring and discussing AI and robotics in nursing and health care before these tools become commonplace is of great importance. We propose that monsters in popular culture might be studied with the hope of learning about situations and relationships that generate empathic capacities in their monstrous existences. ⋯ Monsters therefore serve as an entrance to explore technologic innovations such as AI. Analyzing when and why monsters step out of character can provide important insights into the conceptualization of caring and nursing as a science, which is important for discussing these empathic protocols, as well as more general insight into human knowledge. The relationship between caring, monsters, robotics, and AI is not as farfetched as it might seem at first glance.
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The Permanente journal · Jan 2016
Impact of a Care Directives Activity Tab in the Electronic Health Record on Documentation of Advance Care Planning.
To ensure patient-centered end-of-life care, advance care planning (ACP) must be documented in the medical record and readily retrieved across care settings. ⋯ Statistically significant differences in documentation rates between patients with and without CDA use suggest the potential of a standardized location in the electronic health record to improve ACP documentation. Further research is required to understand effects of CDA use on retrieval of preferences and end-of-life care.