Comparison of blood samples values by direct venipuncture and central venous catheters wi…

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Decibel levels and noise generators on four medical/surgical nursing units.

J Clin Nurs. 2010 Sep;19(17-18):2463-70

Authors: Pope D

The study was designed to determine daytime decibel levels on the hospital’s four medical/surgical nursing units, daytime decibel levels in patient rooms in corresponding nursing units, whether the nursing unit noise levels differed and to identify what generated noise on those units.

PMID: 20920074 [PubMed - indexed for MEDLINE]

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Falls in older hospital inpatients and the effect of cognitive impairment: a secondary analysis of prevalence studies.

J Clin Nurs. 2011 Jan;20(1-2):175-183

Authors: Härlein J, Halfens RJ, Dassen T, Lahmann NA

Aims and objectives.? The objective of this study was to compare fall rates in older hospital inpatients with and without cognitive impairment. Relationships between age, gender, mobility, cognitive impairment, care dependency, urinary incontinence and medical disciplines were investigated. Background.? Falls are common in older people with cognitive impairment, but studies in the hospital setting are rare. Design.? A secondary analysis of three nationwide prevalence studies in German hospitals from the years 2005, 2006 and 2007 was conducted. Method.? Trained staff nurses used a standardised instrument to collect data about accidental falls within the last two weeks in their institutions and about other patient characteristics. Data from 9246 patients aged 65?years or older from 37 hospitals were analysed. Results.? The fall rate for cognitively impaired patients was 12·9%, while only 4·2% of older persons without cognitive impairment experienced a fall. Comparison between medical disciplines showed great differences concerning fall risk for confused and non-confused inpatients. In multivariate logistic regression analysis, the odds-ratio association of cognitive impairment and falls was 2·1 (CI 1·7-2·7). Higher age (OR 1·5, CI 1·2-1·9), greater care dependency (OR 1·6, CI 1·1-2·1), reduced mobility (OR 2·6, CI 1·9-3·7) and being a patient on a geriatric ward (OR 1·8, CI 1·1-2·9) were also statistically significant predictors in this model. Conclusions.? Cognitively impaired older people constitute a high-risk group for accidental falls in hospitals. Relevance to clinical practice.? Fall prevention strategies in the hospital setting should address cognitively impaired inpatients as an important high-risk group.

PMID: 21158990 [PubMed - as supplied by publisher]

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Sleep quality and sleep disturbing factors of inpatients in a Chinese general hospital.

J Clin Nurs. 2009 Sep;18(17):2521-9

Authors: Lei Z, Qiongjing Y, Qiuli W, Sabrina K, Xiaojing L, Changli W

AIMS AND OBJECTIVE: This study was undertaken to determine sleep quality and sleep disturbing factors of inpatients and to compare the perception of sleep disturbing factors between nurses and inpatients in a Chinese general hospital. BACKGROUND: Sleep aids patients’ recovery. A variety of factors affect inpatients’ sleep quality. Current research on inpatients’ sleep quality in China is limited and narrowly focuses on patients in intensive care units or older patients. DESIGN: Survey. METHODS: This research was conducted in a Chinese general hospital. The Pittsburgh Sleep Quality Index and self-designed questionnaires were used to examine inpatients’ sleep quality and compare perceptions of sleep disturbing factors between 397 inpatients and 101 nurses. The following statistical methods were used to evaluate the data: chi-square test, logistic regression analysis and Z statistic. RESULTS: Patients reported poor sleep quality (45.6%) during hospitalisation and a reduction in sleep quality after hospitalisation (57.4%). The chi-square and logistic regression analysis showed that the main sleep disturbing factors were worries about illness, discomfort associated with diseases, using the toilet at night and noise from nurses’ shoes. There was a significant difference in the perception of sleep quality and sleep disturbing factors between inpatients and nurses. CONCLUSION: This study demonstrates that most inpatients reported sleeping problems stemming from multiple sources. Additionally, there was a significant difference in the perception of sleep disturbing factors between nurses and inpatients. RELEVANCE TO CLINICAL PRACTICE: Our survey shows that most nurses are aware of inpatients’ poor sleep quality. However, many patients continue to suffer from poor sleep during hospitalisation because of a wide range of sleep disturbing factors. This suggests that nurses need to be better educated and trained to minimise sleep disturbing factors and improve sleep quality of inpatients.

PMID: 19694879 [PubMed - indexed for MEDLINE]

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A systematic review of wound cleansing for pressure ulcers.

J Clin Nurs. 2008 Aug;17(15):1963-72

Authors: Moore Z, Cowman S

AIM: The aim of this study was to use a Cochrane systematic review process to explore the effect of wound cleansing solutions and techniques on pressure ulcer healing. BACKGROUND: Pressure ulcers impose a significant financial burden on health care systems and negatively affect the quality of life. Wound cleansing is an important component of pressure ulcer care; however, there is uncertainty regarding best practice. DESIGN: Systematic review. METHODS: The Specialised Trials Register of the Cochrane Wounds Group, the Cochrane Central Register of Controlled Trials and bibliographies of relevant publications were searched. Drug companies and experts in the field were also contacted. Randomized controlled trials (RCTs) comparing wound cleansing with no wound cleansing, or different wound cleansing solutions, or different cleansing techniques, were eligible for inclusion. For dichotomous outcomes, relative risk (RR) plus 95% confidence intervals (CI) were calculated; for continuous outcomes, weighted mean difference plus 95% CI were calculated. Meta analysis was not conducted because of the small number of diverse RCTs identified. RESULTS: No studies compared cleansing with no cleansing. A statistically significant improvement in healing occurred for wounds cleansed with saline spray containing Aloe vera, silver chloride and decyl glucoside (Vulnopur) compared with isotonic saline (p = 0.025). No statistically significant change in healing was seen when water was compared with saline (RR 3.00, 95% CI 0.21, 41.89). No statistically significant change in healing was seen for ulcers cleansed with, or without, a whirlpool (RR 2.10, 95% CI 0.93-4.76). CONCLUSION: There is little trial evidence to support the use of any particular wound cleansing solution or technique for pressure ulcers. Relevance to clinical practice. No firm recommendations for ways of cleansing pressure ulcers in clinical practice can be made, the lack of RCT evidence should be a concern for health care providers.

PMID: 18705777 [PubMed - indexed for MEDLINE]

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Improving the patient’s experience of a bone marrow biopsy – an RCT.

J Clin Nurs. 2008 Mar;17(6):717-25

Authors: Johnson H, Burke D, Plews C, Newell R, Parapia L

AIMS: To compare nitrous oxide 50%/oxygen 50% (N(2)O/O(2)- entonox) plus local anaesthetic (LA) with placebo (oxygen) plus LA in the management of pain experienced by patients undergoing a bone marrow biopsy. BACKGROUND: Bone marrow biopsies are a common procedure for many haematological conditions. Despite the use of a LA, pain during the procedure has frequently been reported by patients. Previous research in pain management of other invasive diagnostic procedures (e.g. sigmoidoscopy) has reported N(2)O/O(2) as an effective alternative to LA. DESIGN: Double-blind randomized controlled trial. METHODS: Forty-eight patients requiring a bone marrow biopsy were randomized to receive either N(2)O/O(2) or oxygen in addition to their LA. Participants were asked to complete a pain score and comment on their experience of the procedure. RESULTS: Although the overall pain scores were moderate, there was a wide range of scores. N(2)O/O(2) resulted in significantly less pain for men, but not for women. All patients who had had previous biopsies reported significantly more pain, regardless of the gas used. There were no significant adverse effects in either group. CONCLUSION: N(2)O/O(2) is a safe, effective, easy-to-use analgesic which merits further investigation in potentially painful diagnostic (and other) interventions. Relevance to clinical practice. Relief of pain is an important issue for nurses. Appropriate assessment of pain experience is a key issue. Nurses should reflect on their own area of practice and identify what is known about the effectiveness of pain management from their patient’s perspective. Individual differences may be important, and careful instruction regarding appropriate administration of analgesic agents, such as N(2)O/O(2) may enhance their effectiveness.

PMID: 18047576 [PubMed - indexed for MEDLINE]

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