Care Procedures (care + procedure)

Distribution by Scientific Domains

Selected Abstracts

Field Guide to Urgent and Ambulatory Care Procedures

Bryan Walpole
No abstract is available for this article. [source]

Kangaroo Mother Care, home environment and father involvement in the first year of life: a randomized controlled study

R Tessier
Abstract Aims:, This study tested the hypothesis that Kangaroo Mother Care creates a climate in the family, which enhances infants' performance on the developmental quotient scale. Setting:, The largest social security hospital in Colombia with a neonatal intensive care unit. Subjects:, At 12 months of corrected age, 194 families in the Kangaroo Mother Care group and 144 families in the Traditional Care group were available for analysis. Interventions:, Infants were kept 24 h/day in an upright position, in skin-to-skin contact until it was no longer tolerated by the infants. Babies in the Traditional Care were kept in incubators on the Minimal Care Unit until they satisfied the usual discharge criteria. Outcome measures:, The Home Observation for Measurement of the Environment (HOME), Father Involvement and Developmental Quotient (Griffiths) scores. Results:, 1) Kangaroo mothers created a more stimulating context and a better caregiving environment than mothers in the Traditional Care group; 2) this environment was positively correlated to father involvement and 3) the family environment of male infants was most improved by Kangaroo Mother Care. Conclusion:, Kangaroo Mother Care has a positive impact on home environment. The results also suggest, first, that both parents should be involved as direct caregivers in the Kangaroo Mother Care procedure and secondly, that this intervention should be directed more specifically at infants who are more at risk at birth. The Kangaroo Mother Care intervention could be an excellent means to ensure parents' mature involvement in the future of their children. [source]

Complete Recovery From Intractable Complex Regional Pain Syndrome, CRPS-Type I, Following Anesthetic Ketamine and Midazolam

PAIN PRACTICE, Issue 2 2007
Ralph-Thomas Kiefer MD
Abstract Objective: To describe the treatment of an intractable complex regional pain syndrome I (CRPS-I) patient with anesthetic doses of ketamine supplemented with midazolam. Methods: A patient presented with a rapidly progressing contiguous spread of CRPS from a severe ligamentous wrist injury. Standard pharmacological and interventional therapy successively failed to halt the spread of CRPS from the wrist to the entire right arm. Her pain was unmanageable with all standard therapy. As a last treatment option, the patient was transferred to the intensive care unit and treated on a compassionate care basis with anesthetic doses of ketamine in gradually increasing (3,5 mg/kg/h) doses in conjunction with midazolam over a period of 5 days. Results: On the second day of the ketamine and midazolam infusion, edema, and discoloration began to resolve and increased spontaneous movement was noted. On day 6, symptoms completely resolved and infusions were tapered. The patient emerged from anesthesia completely free of pain and associated CRPS signs and symptoms. The patient has maintained this complete remission from CRPS for 8 years now. Conclusions: In a patient with severe spreading and refractory CRPS, a complete and long-term remission from CRPS has been obtained utilizing ketamine and midazolam in anesthetic doses. This intensive care procedure has very serious risks but no severe complications occurred. The psychiatric side effects of ketamine were successfully managed with the concomitant use of midazolam and resolved within 1 month of treatment. This case report illustrates the effectiveness and safety of high-dose ketamine in a patient with generalized, refractory CRPS. [source]

Functional skin adaptation in infancy , almost complete but not fully competent

Joachim W. Fluhr
Please cite this paper as: Functional skin adaptation in infancy , almost complete but not fully competent. Experimental Dermatology 2010; 19: 483,492. Abstract:, Early postnatal life is a period of active functional reorganization and cutaneous physiological adaptation to the extrauterine environment. Skin as the outermost organ of mammalians is endowed of multiple functions such as protection, secretion, absorption and thermoregulation. Birth stimulates the epidermal barrier maturation and the skin surface acidification especially in premature infants. In full-term infants the developed stratum corneum accomplishes competent barrier function, in contrast to prematures. Complete barrier maturation in preterm infants is fulfilled by 2,4 weeks of the postnatal life. However, in preterms with 23,25 weeks gestational age this process takes longer. Versatile regulatory mechanisms, namely skin surface acidity, calcium ion gradient and nuclear hormone receptors/ligands are interrelated in the complex postnatal newborn adaptation. The skin of newborns is adjusting quickly to the challenging environmental conditions of the postpartum. However, certain functions, for example, microcirculation, continue to develop even beyond the neonatal period, that is, up to the age of 14,17 weeks. Different environmental factors (for instance, dry and cold climate, diapers and cosmetic care procedures) influence the postnatal development of skin functional parameters such as stratum corneum hydration and the permeability barrier especially in premature infants. The aim of this article is to summarize the current knowledge on skin physiology in newborn and infants with a practical approach and to discuss the possible clinical consequences. This review offers the readership a critical and practical overview of skin physiology in newborns and infants. It emphasizes possible new research fields in neonatal and infantile skin physiology. [source]

The spectrum of barriers to and facilitators of research utilization in Iranian nursing

Neda Mehrdad MSN
Aim., The focus of the study is the identification of barriers to and facilitators of research utilization in nursing practice from the perspective of Iranian nurses. Background., In Iran, research utilization is a new phenomenon thus our knowledge with regard to those factors that promote or discourage research use is limited. No overall picture of the state of research utilization in Iran therefore exists. Method., A descriptive design is used. The questionnaire was distributed to 410 nurses from educational hospitals and nursing schools affiliated with Tehran Medical Sciences University in Iran. Results., The major barriers to research utilization were that the nurses do not have time to read research; facilities are inadequate for implementation; and nurses do not feel they have enough authority to change patient care procedures. Findings revealed a number of facilitators which were categorised into two main groups of human resources and individual/organisational factors. Conclusion., The healthcare system in Iran does not provide the incentive for nurses to engage in research or to avail themselves of research findings. Also, time is the major issue owing to a nursing shortage. If research utilization is to increase in Iran, therefore, the most important organisational change that needs to occur is the provision of available facilities for nurses to use research evidence. Relevance to clinical practice., Key factors that need attention in implementing research results into practice are suggested. Clearly, identification of barriers and facilitators is useful potentially to overcome barriers and enforce facilitators and this could ultimately improve nursing practice. [source]

Evaluation of negative emotional care experiences in burn care

Björn Wikehult MSc
Aim and objective., To assess recollection of negative emotional experiences during burn care. Background., Patients in intensive care frequently report negative emotional experiences. Patients with severe burns who are treated in intensive care units undergo painful care procedures, but there have been no recent evaluations of their care experiences. Design., Former burn patients (n = 42) were randomly assigned to three groups: postal questionnaire, telephone interview and face-to-face interview. Methods., Assessments included negative care experiences (feelings of uncertainty, powerlessness, being afraid, insecure, being a nuisance, or neglected), severity of injury, patient satisfaction, personality traits and psychological symptoms. Results., Overall, the degree of recalled negative experiences was low and associated with greater severity of injury, more symptoms of post-traumatic stress disorder and lower satisfaction with care. The feeling of powerlessness was the most common, as 67% of participants had such feelings to some extent. Conclusions., Overall, negative care experiences were uncommon and most prevalent among the severely injured. Such experiences were also associated with psychological symptoms and lower patient satisfaction. Relevance to clinical practice., Although relatively uncommon, negative emotional care experiences should be monitored more closely during care. [source]

Microbial contamination of contact lenses and lens care accessories of soft contact lens wearers (university students) in Hong Kong

M. S. Yung
Abstract Purpose:, This study aimed to examine the rates of microbial contamination, and identify contaminants associated with contact lenses and lens care accessories used by a group of young contact lens wearers. Methods:, Collected contact lenses, lens cases, and lens care solutions were studied by bacterial culture. Contamination rates of these samples were recorded and compared with those reported in previous studies. Results:, Of the samples tested, 9% of lens extracts, 34% of case extracts and 11% of solution samples were contaminated with ocular pathogenic microorganisms. Serratia spp., Staphylococcus aureus and coagulase-negative staphylococci were the most common microorganisms isolated. Lens cases were the most frequently contaminated item. Lens cases also yielded the widest range of bacterial isolates. Contact lenses used by occasional wearers were associated with a higher contamination rate. Using either saline or multipurpose solution to rinse lenses before use appeared to be effective in reducing incidence of contamination. Conclusion:, Our findings demonstrate that contact lenses and lens care accessories are not well maintained by contact lens wearers. Regular reviews and reinforcement of lens care procedures for the usage and care of contact lenses and lens care accessories is therefore important and essential. [source]

Patient involvement in health-related decisions during prolonged critical illness,

Mary Beth Happ
Abstract We describe patterns of communication of patients involved in health-related decision making during prolonged mechanical ventilation (PMV). Data were collected using observation, interview, and record review. Twelve of 30 patients participated in decisions about initiating, withdrawing, and withholding life-sustaining treatment, surgery, artificial feeding, financial/legal issues, discharge care, and daily care procedures. Patient involvement was largely validation or confirmation of what clinicians and families had already decided. Patients' participation was enlisted by clinicians and family members even when the patients did not exhibit full decisional capacity. Patient involvement in health-related decisions during prolonged critical illness is a shared and negotiated process that requires continued empirical study and ethical analysis. © 2007 Wiley Periodicals, Inc. Res Nurs Health 30:361,372, 2007. [source]