Medsurg nursing : official journal of the Academy of Medical-Surgical Nurses
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Customer demands and financial pressures have forced hospitals to reassess the quality of their services and the efficiency with which they are delivered. A number of institutions have turned to continuous quality improvement methods to help streamline specific processes. For institutions to survive, however, they must look beyond specific processes to broader issues of scope of practice. One hospital's use of Juran's BPQM framework helped position the institution for future economic demands.
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A physician-nurse collaborative team developed and implemented a research-based protocol and algorithm for improving vital signs monitoring and early intervention for at-risk patients. Project evaluation showed that in general the protocol and algorithm were used appropriately and consistently and prevented negative patient outcomes.
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Current clinical research studying the administration of local anesthetics, opioids, and nonsteroidal anti-inflammatory agents prior to various types of surgery are reviewed. These agents can reduce pain and improve patient management in the postoperative period, but this technique can be controversial. Implications for nurses are discussed.
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It is estimated that by 2025, 25% to 35% of the people in this country will be older than 65 years. One of the hazards facing the elderly is the risk of trauma. ⋯ Despite aggressive care, the elderly trauma patient's chances of a good outcome are slim. However, is it ethical to ration trauma care on the basis of age? A case study of an elderly trauma patient provides an opportunity to apply an ethical decision-making model to the question.