British journal of nursing (Mark Allen Publishing)
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Randomized Controlled Trial Multicenter Study Comparative Study
Nurses' views on ease of patient care in postoperative pain management.
The fentanyl HCl iontophoretic transdermal system (ITS) is a compact, needle-free, pre-programmed patient-controlled analgesic system that was developed to address limitations to existing therapies for postoperative pain management. A randomized, controlled trial was conducted in 11 European countries to evaluate the efficacy and safety of postoperative pain control using fentanyl ITS compared with a standard regimen of morphine provided by an intravenous patient-controlled analgesia (IV PCA) pump. ⋯ Nurses' ratings of patient-care tasks associated with each pain management system were significantly more favourable for fentanyl ITS than for morphine IV PCA. These findings suggest that nurses consider fentanyl ITS to be easier to use than morphine IV PCA.
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Providing a clean, comfortable bed and positioning a patient in the optimum posture for prevention of complications and to enable maximum independence are fundamental nursing skills. Bed-making is a daily routine that requires practical and technical skills. ⋯ In this article bed-making is described, as are positioning and re-positioning in relation to patients in bed, armchairs and wheelchairs. Infection control and moving and handling issues are also considered.
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What are the implications of caring for patients with advance directives in emergency care contexts? This paper examines legal and professional perspectives and highlights the challenges that practitioners face. Emergency care contexts necessitate the need for timely decision making regarding care and treatment options. ⋯ They are also legally binding documents and represent the wishes of a patient, but often with little prior knowledge of the patient, practitioners may be unsure whether to act on an advance directive. This paper makes some attempt to examine key components of this debate.