Validation of concept mapping between PNDS and SNOMED CT

THE PERIOPERATIVE NURSING DATA SET (PNDS) is a structured vocabulary developed by AORN to help document perioperative nursing practices.THE PNDS HAS BEEN MAPPED To the Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) reference terminology model to support the electronic exchange of nursing data.THIS STUDY VALIDATES the concept mapping between the PNDS and SNOMED CT, supporting an equivalent meaning of concepts between the two terminology systems. AORN J 87 (June 2008) 1217-1229. © AORN, Inc, 2008.     

Antiarthritic effects of relaxin, in combination with estrogen, in rat adjuvant-induced arthritis

The incidence and severity of rheumatoid arthritis (RA) are reduced during pregnancy. Estradiol-17beta and relaxin (RLX), hormones of pregnancy, are implicated in decreased immune responsiveness. The aim of this study was to determine the effects of estrogen and RLX, alone or in combination, on the development of adjuvant-induced arthritis (AIA) in ovariectomized (OVX) Lewis rats. Arthritis was induced on day 0 by adjuvant injection in the left hind paw. Rats were treated with estradiol valerate (E), porcine RLX, E + RLX, or vehicle. Healthy OVX control animals were used for comparison. Treatment with RLX or E alone decreased adjuvant-induced inflammation in both the injected (primary) and noninjected (secondary) hind paws. Combined treatment with E and RLX was more effective than either hormone alone in blocking secondary paw inflammation. Furthermore, E plus RLX reduced changes to spleen and thymus weights induced by adjuvant injection. Both E and RLX alone decreased circulating tumor necrosis factor (TNF) alpha. The combination of E and RLX resulted in a greater decline in TNFalpha than treatment with either hormone alone. There was no effect of hormones on the proinflammatory cytokine, interleukin (IL)-1beta. The anti-inflammatory cytokine IL-10 increased in response to E and E plus RLX. In conclusion, combined therapy with E and RLX was more effective than either hormone alone in reducing chronic inflammation, joint changes, and high circulating TNFalpha associated with AIA in rats. Accordingly, these hormones could play a role in reducing RA-induced inflammation during pregnancy by an effect on the immune system.     

Educating advanced practice nurses for collaborative practice in the multidisciplinary provider team

PURPOSE: To describe the use of a clinical decision-making work sheet as a tool to teach communication skills to advanced practice nurse (APN) students. Achievement of competencies in communication and documentation that utilize language and communication strategies that are shared with other health professionals promotes effective collaborative practice among members of the multidisciplinary provider team. DATA SOURCES: Review of the recent Institute of Medicine report on health professions education and other health professional literature. CONCLUSIONS: The Clinical Decision-Making Work Sheet helps APN students effectively communicate in real-world clinical settings. The clinical work sheet allows nurse practitioner students to communicate more effectively and efficiently, using a vocabulary that is shared with other members of the multidisciplinary health care provider team. Use of the tool in students' clinical-rotation settings facilitates effective application and refinement of the clinical decision-making skills that students learned in the advanced health assessment course. IMPLICATIONS FOR PRACTICE: Faculty have the responsibility to assist nurses as they transition from traditional nursing to APN roles. The work sheet facilitates learning the common language for data collection, clinical decision making, documentation, and reporting that is shared with other health professionals. Using the tool, students learn to efficiently organize information that supports communication and documentation that enhances their clinical problem-solving skills. Case presentation and documentation using the work sheet provide a basis for preceptor and student interaction and for student evaluation.     

Spiritual caring: end of life in a nursing home

The purpose of this qualitative study was to explore spiritual care for dying nursing home residents from the perspectives of registered nurses, practical nurses, certified nursing assistants, advanced practice nurses, and physicians. Five major themes emerged: honoring the person's dignity, intimate knowing in the nursing home environment, wishing we could do more, personal knowing of self as caregiver, and struggling with end-of-life treatment decisions. Spiritual caring was described within the context of deep personal relationships, holistic care, and support for residents. Spiritual care responses and similarities and differences in the experiences of participants are presented. Education and research about how to assist residents and families as they struggle with difficult end-of-life decisions, adequate time and staff to provide the kind of care they "wished they could," and development of models that honor the close connection and attachment of staff to residents could enhance end-of-life care in this setting.     

Liver damage,proliferation, and progenitor cell markers in experimental necrotizing enterocolitis

Background

Necrotizing enterocolitis (NEC) is a disease known to cause injury to multiple organs including the liver. Liver regeneration is essential for the recovery after NEC-induced liver injury. Our aim was to investigate hepatic proliferation and progenitor cell marker expression in experimental NEC.

Geographic modeling for children at risk for home fires and burns

This study developed a predictive model for fires and burns among parents and children in Jefferson County, Kentucky. Eight risk factors for pediatric burns with census tract level data available were identified. Risk factors were synthesized to develop a cartographic model with risk levels low, medium, high, and severe. Validation was performed with fire dispatch data. At-risk areas were concentrated in the county’s northwest. Risk was correlated with fire incidence rate (ρ = 0.67, p < 0.001). Significant risk factors were race (β = 0.54, p < 0.001), education (β = 0.38, p < 0.001), and year home built (β = ?0.17, p = 0.005). Cartographic modeling is a underutilized tool to identify at-risk areas.     

Preoperative assessment in patients presenting for elective surgery

Preoperative assessment of patients undergoing elective surgery is vital to ensure patients have underlying comorbidities identified, appropriate investigations performed and are optimized prior to the day of surgery. Anaesthetic pre-assessment is usually initiated at the pre-assessment clinic. A thorough assessment should include a careful history and examination as well as assessment of both the airway and functional capacity. This article provides a systematic approach to the assessment process.     

Culturing Periprosthetic Joint Infection: Number of Samples,Growth Duration,and Organisms

Background

Owing to the difficulty isolating microorganisms in periprosthetic joint infection (PJI), current guidelines recommend that 3-5 intraoperative samples be cultured and maintained for 3-14 days. We investigated (1) the optimal number of culture samples and growth duration to diagnose PJI and (2) the microbiology profile at our institution.

Fourteen Year Follow-Up of Randomized Clinical Trials of Active Robotic-Assisted Total Hip Arthroplasty

Background

Active robotic total hip arthroplasty (THA) has been used clinically for over 20 years, but long-term results have never been studied. The aims of this study are to determine whether active robotic THA improves clinical outcomes and results in fewer revisions over a long-term follow-up.