Axone (Dartmouth, N.S.)
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Axone (Dartmouth, N.S.) · Sep 1994
Comparative Study Clinical Trial Controlled Clinical TrialA comparative study of systemized vs. random tracheostomy weaning.
The purpose of this study was to compare a systematic tracheostomy weaning procedure to a random weaning approach by asking the question: "What is the benefit to the patient of a systematic vs. random weaning process for tracheostomy removal as defined by the number of weaning attempts and post-weaning complications?" A tracheostomy weaning procedure was developed at St. Boniface General Hospital as a joint venture between the neuroscience nurses and neurosurgeons in response to a perceived clinical need. This project evaluated the systemic procedure in two neuroscience units in Manitoba on ten adult patients who met the assessment criteria for tracheostomy removal established in the procedure. ⋯ Content analysis of the retrospective data indicates that the random tracheostomy weaning procedure was subject to the individual nurses' judgement. The systemized procedure was more standardized and conformed to the protocols in the procedure. Most importantly, the patient's comfort and safety were greatly enhanced through the use of standard tracheostomy weaning procedure.
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Axone (Dartmouth, N.S.) · Jun 1994
Length of hospital stay and contributing variables in supratentorial craniotomy patients with brain tumour: a pre-care map study.
The study included 70 patients admitted to Neurosurgical ICU (NICU) with the diagnosis of Supratentorial Craniotomy for Brain Tumour. These patients were followed throughout their hospitalization in NICU, to the ward and until discharge from hospital. The purposes of the study were (a) to indicated the NICU and floor length of stay (LOS) in this group of patients, prior to the use of care map and compare it to a developed care map, and (b) to identify the variables that contribute toe overall prolonged hospital LOS. ⋯ The findings also showed that the overall hospital LOS, in 71.4% of the patients, was over 7 days, as indicated on the developed care cap. Several variables such as patient complications, consults, rehab/placement, patient falls and additional diagnostic tests contributed to the overall pronged hospital LOS. Thus, by monitoring these variables with the use of a care map, may produce measurements to evaluate cost effectiveness, and allow health care professionals to provide more effective and quality patient care.
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Axone (Dartmouth, N.S.) · Sep 1992
The cardiopulmonary complications of aneurysmal subarachnoid hemorrhage: current trends in management.
It is well established that excessive sympathetic activity, resulting in the development of cardiopulmonary complications, commonly occurs in patients who have suffered aneurysmal subarachnoid haemorrhage. Cardiac dysfunction and neurogenic pulmonary edema are life threatening conditions that have serious implications with regard to patient outcome. The purpose of this article is to familiarize the neuroscience practitioner with the effects of subarachnoid haemorrhage on the heart and lungs and to provide an update in terms of current medical and nursing management trends. ⋯ A brief review of the anatomy and physiology of the sympathetic division of the autonomic nervous system will be presented. In addition, the theories that have been proposed to explain the underlying pathogenesis will be introduced. Medical and nursing management strategies will also be addressed.
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Today much of our knowledge about a patient's level of consciousness is given to us by his or her score on the Glasgow Coma Scale (GCS). Since its development at the University of Glasgow in 1974, it has been widely adopted, become an integral component of the hourly "neuro assessment", and is typically incorporated into the graphic assessment portion of the patient's medical record. Once the information has been documented, the pure data itself is lost as the documented form takes on an interpretative meaning or a reality that is different from the clinical state experienced by the patient. ⋯ These are important as they are not visible in the scale itself; however, their effects are evident in the coma score obtained. These forces include the design of the GCS and the manner in which the tool is taught and used. The purpose of this paper is to discuss these factors and to delineate how they create a reality that may not accurately depict the patient's level of consciousness.