Applying developmental principles to diagnosis and treatment of conflict

Previewing a developmental process derived from caregiver-infant interaction, may offer benefits for adult psychotherapy that are not provided by traditional techniques. The previewing process with infants takes place when the caregiver becomes aware of skills that the infant will soon develop and devises behavioral exercises that introduce the infant to the experience of acquiring those skills.Using previewing with adults helps the therapist assess the patient's representations of future events, circumvents defensive operations by orienting the patient to those events, and provides the patient with strategies for coping with potential conflict. As a technique for caregivers who have problematic relationships with their children, previewing may revive patterns of interaction that promote adaptive development.     

Applying the principles of infection control to wound care

Human skin in healthy adults is inhospitable organisms. A wound may occur from any accidental or deliberate trauma that breaks the surface of the skin. Once this line of defence is broken there is a risk of infection. All soft tissue injuries, whether chronic, traumatic or surgical, involve the same basic biochemical and cellular processes. This article looks at the risk factors associated with healing of such wounds. The principles of asepsis, wound cleansing agents, choice of dressings and the taking of wound swabs are considered.     

Applying the key principles of nutrition to nursing practice

This article outlines the importance of good nutrition in adults and children. With reference to adult nursing, the article highlights the benefits of nutritional screening of patients, identifies alternative foods for undernourished patients, and discusses why feeding and planning meal times are vital aspects of patient care. In terms of paediatric nursing, the article discusses the implications of childhood obesity and the importance of eating the right balance of foods.     

Applying palliative care principles and practice to emergency medicine

Only recently has the potential (unmet) palliative care (PC) workload in the ED been recognised. While confident in PC symptom management, we underestimate the role of a palliative approach in non‐cancer diagnoses and seek education in areas such as individual patient care pathways, ethical and legal issues and difficult conversations at the end of life. PC is best introduced early for a range of life‐limiting cancer and non‐cancer diagnoses. Allowing patients time to tell their story with active listening, acknowledgement of suffering and a compassionate presence leads to treatment ‘success’ that is not defined by cure. This patient‐centred, rather than disease‐centred approach, is the essence of PC, and one that is easily incorporated into emergency practice. PC and disease‐specific treatments can comfortably coexist, and with meticulous symptom management, may actually prolong life. PC is everyone's business, and emergency medicine needs to be part of it.     

Applying e-health to case management

The healthcare industry is only beginning to understand e-health. E-health can be defined as the use of technology to directly improve healthcare delivery-affording patients the opportunity to participate in their own healthcare management, provider, and institution. The market is changing rapidly, and innovations, partnerships, and mergers are taking place daily. For healthcare institutions, setting a long-term, yet adaptable e-health strategy is of vital importance for the continued success of the organization. For clinicians, an understanding of and familiarity with technologies can significantly improve workflow, organization, and patient interaction. For the patient, technology can be leveraged as a means to take initiative and responsibility for his/her own health. This article defines e-health and explains the implications and benefits of e-health to nurses and their patients. The article also identifies unique opportunities e-health/e-commerce can provide case managers in promoting patient connectivity, care management, and economy in cost of care.     

Applying exercise to the management of fibromyalgia

Fibromyalgia, chronic fatigue syndrome, and related illnesses fall under the spectrum of chronic multisymptom illnesses (CMI). This constellation of syndromes often is defined by chronic pain, unremitting fatigue, cognitive difficulties, and various other symptoms. In treating these illnesses, pharmacotherapy generally is the mode of choice, with exercise being overlooked often. However, research has shown that exercise is quite beneficial in reducing pain and fatigue in this population and should be included as part of a multimodal therapy regimen. This article reviews the exercise and CMI literature and provides a model for applying these evidence-based guidelines to a clinical population.     

Blood banking issues pertaining to neonatal red blood cell transfusions

Many preterm infants are given multiple red blood cell transfusions during the early weeks of life. Because firm standards for neonatal transfusions do not exist, it is important to consider the pathophysiology of the anemia of prematurity, the goals of transfusion therapy and blood banking practices that best provide safe and effective neonatal transfusions. There is increasing agreement that efforts continue to minimize phlebotomy blood losses, to transfuse per conservative indications and to limit donor exposure by transfusing stored red blood cells from a single unit reserved for an infant--rather than insisting on fresh blood.     

Automation in blood banking and hemotherapy

In summary, although instrumentation related to blood bank and transfusion medicine is not new, it is not yet widely available in smaller blood collection facilities and hospitals. Advances in technology with microplate processing and the changes in resources available for the blood bank, such as the technologist shortage, have led to development of smaller systems. This trend is expected to continue, with the development of instruments having improved capability for antiglobulin testing. Autologous blood salvage works well with both the canister systems and the high-speed continuous flow instruments. Given the increasing demand to avoid transfusion of homologous blood, the applications of this technology will expand, and it is likely that technological improvements will be made.