Evidence-based nursing
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Evidence-based nursing · Apr 2015
CommentHigher numbers of nurses and consultants improve survival rates for critically ill patients.
Implications for practice and research: The number of nurses, as well as doctors, working in intensive care units (ICUs) is associated with patient mortality. Patients at high risk of death are more vulnerable if they are admitted to ICUs with lower nurse staffing, while higher unit workload in ICUs is associated with higher patient mortality. Future research would be aided by the establishment of standardised national electronic databases.
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Evidence-based nursing · Apr 2015
CommentHealth professionals' pain management decisions are influenced by their role (nurse or physician) and by patient gender, age and ethnicity.
Implications for practice and research: Healthcare providers from different fields may respond differently to patients with pain. On average, nurses rated pain intensity higher than physicians and were more likely to prescribe opioids. Patient demographic characteristics may influence nurses' and physicians' perceptions of pain intensity and decisions to treat pain with opioid analgesics. This study must be replicated with a more robust study design before findings can be translated into recommendations for intervention.
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Evidence-based nursing · Apr 2015
CommentA decision tree incorporating biomarkers and patient characteristics estimates mortality risk for adults with septic shock.
Implications for practice and research: Wong and colleagues' study improves on current risk stratification models for sepsis. The study's findings may lead to more homogeneous patient populations enrolled into clinical trials, increasing the chance of successful development of novel therapies for sepsis. There are no immediate practice implications, due to clinically unavailable biomarker tests and a cumbersome algorithm.
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Evidence-based nursing · Apr 2015
CommentReview: femoral nerve block may be the most effective option for pain relief following total knee replacement.
Implications for practice and research: Utilisation of continuous femoral nerve blockade (FNB) following knee replacement surgery can provide superior pain relief and fewer side effects, compared to traditional patient-controlled opioid analgesia. Further research is needed to compare the effectiveness of FNB to other pain management strategies, such as local anaesthetic infiltration and multimodal oral pain medication.
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Evidence-based nursing · Apr 2015
CommentIncreasing nurse staffing levels and a higher proportion with bachelor's degrees could decrease patient mortality risk.
Implications for practice and research: Hospital efforts to save costs by reducing nursing staff may contribute to 30-day in-hospital mortality, while more nurses prepared at the baccalaureate level may help prevent adverse outcomes. Policymakers need nurse staffing level recommendations based on scientific, business, social and political evidence in order to act.