British journal of nursing (Mark Allen Publishing)
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Endotracheal suctioning is a common aspect of nursing care to mechanically-ventilated patients. The aim of this study was to investigate the effects of two suctioning techniques on oxygen saturation (SaO2) and the amount of drained secretions. A quasi-experimental study of 103 mechanically-ventilated patients was conducted from two tertiary hospitals in Greece. ⋯ In addition, suctioning without normal saline instillation was associated with a decrease in SaO2 1 minute (p<0.001) after the suction. In conclusion, normal saline instillation is related with a negative outcome on patient oxygenation for a prolonged period after the suction and causes the removal of a greater amount of secretions than the applied technique with no instillation. Comparing the two techniques, none is superior to the other resulting from the statistically insignificant comparative differences in SaO2 values.
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This article explores the decision in the case of W v M, S and an NHS Primary Care Trust [2011] EWHC 2443 (Fam) in which an application to withdraw feeding from a woman in a minimally conscious state was rejected by Baker J in the Court of Protection. The article places the case in the context of the development of case law concerning the withdrawal of treatment from patients lacking decision-making capacity, where death will be the inevitable consequence of the withdrawal of treatment after the decision in Airedale NHS Trust v Bland. It questions whether nearly two decades after the Bland decision there is scope for the boundaries of the decision to withdraw treatment from patients in 'futile' conditions to be reconsidered by the Supreme Court.
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Comparative Study Clinical Trial
Laboratory performance of alternating pressure air mattresses component and sequelae.
The performance of three different alternating pressure air mattresses with different geometries of air cell were compared (Nimbus 3, Heritage, Tamora Plus), using simple performance indices based on pressure mapping. The aim of this study was to examine the effect on performance of elevating the backrest and thigh section of the bed into sitting position. Ten healthy volunteers of various sizes were pressure-mapped over the full pressure cycle on three alternating pressure air mattresseses with differing cell geometries. ⋯ Performance of the alternating pressure air mattresses in terms of their ability to redistribute pressure dynamically was assessed in the different positions. The different alternating pressure air mattresses performed similarly with the bed in the lying flat position, but smaller cells appeared to be more effective in the sitting position. A conclusion was made that cell geometry may have an effect on the ability of the mattress to achieve alternating behaviour in the sitting position.
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Professor Alan Glasper discusses the Department of Health's Duty of Candour consultation, which is reminiscent of the NPSA's Being Open Framework in its aims for openness across health care and creating a more accountable and transparent NHS.
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The use of enteral feeding tubes, such as nasogastric and gastrostomy tubes, to support a patient's nutritional intake is generally considered to be safe and effective. However, recent alerts and recommendations from the National Patient Safety Agency (NPSA) regarding enteral feeding have led health professionals to review their practice and guidelines. This article explores safe practice in enteral tube feeding in the light of three NPSA alerts: Promoting safer measurement and administration of liquid medicines via oral and other enteral routes (2007), Early detection of complications after gastrostomy (2010) and Reducing the harm caused by misplaced nasogastric tubes in adults and children (2011).