International journal of nursing studies
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Although sucrose is most extensively examined for its analgesia effect on a single procedural pain, neonates in neonatal intensive care units can be exposed to numerous painful procedures every day requiring multiple doses of sucrose. Some experiments have been performed to examine the efficacy and safety of repeated sucrose administration for repeated procedural pain; however, a systematic review of this topic has not yet been carried out. ⋯ Evidence regarding the efficacy and safety of repeated sucrose across repeated procedural pain for neonates is limited. More prospective, multi-centered, large randomized controlled clinical trials with a standardised study design are required before sucrose can be recommended widely as an analgesia for repeated procedural pain in neonates.
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To identify recommendations for determining patient panel/caseload size for nurse practitioners in community-based primary health care settings. ⋯ There are few systems in place to track and measure community-based primary health care nurse practitioner activities. The development of such mechanisms is an important next step to assess community-based primary health care nurse practitioner productivity and determine patient panel/caseload size. Decisions about panel/caseload size must take into account the effects of nurse practitioner activities on outcomes of care.
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High profile accounts of failures in patient care reflect an urgent need for transformational development in healthcare. Appreciative Inquiry is promoted as an approach to exploring and bringing about change in social systems. Appreciative Inquiry has been used extensively in North American business since the late 1980s. The application of Appreciative Inquiry may have merit in the complex world of human health experiences. ⋯ Appreciative Inquiry offers potential for nurse practice development and change but not without cognisance of the pivotal components. If Appreciative Inquiry is to be perceived as a legitimate research endeavour, there must be engagement and attention to rigour. Findings suggest caution is required against the choreography of Appreciative Inquiry where participant experiences are moulded to fit a previously drafted master plan. Further research is needed to explore the role of expert facilitation in securing and sustaining successful outcomes of Appreciative Inquiry.
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Review Meta Analysis
Skin antiseptics in venous puncture site disinfection for preventing blood culture contamination: A Bayesian network meta-analysis of randomized controlled trials.
To compare the efficacy of several antiseptics in decreasing the blood culture contamination rate. ⋯ Different antiseptics may not affect the blood culture contamination rate. Different intervals between the skin disinfection and the venous puncture, the different settings (emergency room, medical wards, and intensive care units) and the performance of the phlebotomy may affect the blood culture contamination rate.
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Around the world, guidelines and clinical practice for the prevention of complications associated with central venous catheters (CVC) vary greatly. To prevent occlusion, most institutions recommend the use of heparin when the CVC is not in use. However, there is debate regarding the need for heparin and evidence to suggest normal saline may be as effective. The use of heparin is not without risk, may be unnecessary and is also associated with increased costs. ⋯ It remains unclear whether heparin is necessary for CVC maintenance. More well-designed studies are required to understand this relatively simple, but clinically important question. Ultimately, if this evidence were available, the development of evidenced-based clinical practice guidelines and consistency of practice would be facilitated.