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941.
942.
Mrs Terry Lumsden BS William R. Marshall BS George A. Divers BA SM Samuel D. Riccitelli BA MSEng 《Journal of clinical monitoring and computing》1994,10(1):59-66
Continuous intraarterial blood gas (IABG) monitoring is in clinical use both in the operating room and intensive care unit. This technology uses miniature, optically-based sensors that can be placed into a patient's artery. The arterial blood gas values are transduced into an optical signal that is measured by a bedside monitor on which the values are displayed. In this paper, we describe the operating principles of the PB3300 Intra-Arterial Blood Gas Monitoring System (Puritan-Bennett Corporation, FOxS Division, Carlsbad, CA). Topics include the principles of fluorescent determinations of pH,PCo
2, andPO
2; the optical path of the PB3300; system calibration; dye layer geometry; and clinical operation. The accuracy, precision, and drift of the system measuring tonometered aqueous standards are reported. The following values were noted for eight sensors sending data to eight monitors: system bias and precisions of 0.00±0.02 pH at a pH of 7.40, –2.5±1.5 mm HgPCo
2 at aPCo
2 of 40 mm Hg, and 3.3±1.3 mm HgPO
2 at aPO
2 of 80 mm Hg.
Abstrakt Die kontinuierliche intraarterielle Blutgasüberwachung (IABG) wird klinisch sowohl im OP als auch auf der Intensivstation eingesetzt. Hierbei werden miniaturisierte, optische Sensoren angewandt, die sich direkt in der Arterie des Patienten plazieren lassen. Die Blutgaswerte werden in optische Signale umgesetzt und von einem bettseitigen Monitor gemessen und angezeigt. In dieser Arbeit beschreiben wir das Funktionsprinzip des Intra-Arteriellen Blutgasanalysesystems PB3300 (Puritan-Bennett Corporation, FOxS Division, Carlsbad, CA). Themen sind die Grundlagen der Bestimmung von pH, PCO2 und PO2 mittels Fluoreszenz; die optische Übertragung des PB3300; die Kalibrierung des Systems; die Geometrie der Farbschichten und der Einsatz in der Klinik. Die Genauigkeit, Auflösung und Drift des Systems bei der Messung von tonometrischen wässrigen Standards wird beschrieben. Die folgenden Werte ergaben sich aus einer Meßreihe mit 8 Sensoren, die an 8 Monitore angeschlossen waren (jeweils Bias, Streuung und Sollwert): 0.00±0.02 pH bei 7.40 pH, –2.5±1.5 mmHg PCO2 bei 40 mmHg PCO2 und 3.3±1.3 mmHg PO2 bei 80 mmHg PO2.
Resumen La monitorizaciòn continua de gases intraarteriales tiene uso clinico, tanto en el pabellòn de operaciones como en la unidad de cuidados intensivos. Esta tecnologia utiliza sensores miniatura de tipo òptico que pueden ser introducidos en una arteria del paciente. Los valores de gases arteriales son transducidos en forma de señal òptica que es medida al lado de la cama del paciente por un monitor que presenta los valores numéricos. En este trabajo, describimos los principios de operaciòn del PB3300 Intra-Arterial Blood Gas Monitoring System (Puritan-Bennett Corporation, FOxS Division, Carlsbad, CA). Los temas incluyen los principios de determinaciones fluorescentes de pH, PCO2, and PO2; la via òptica del PB3300; calibraciòn del sistema; geometria de la capa de colorante; y la operaciòn clinica. Se presentan la exactitud, precisiòn, y deriva (drift) del sistema, midiendo soluciones acuosas de tonometrìa estàndar. Los siguientes valores fueron registrados para ocho sensores enviando informaciòn a ocho monitores: los sesgos del sistema y las precisiones fueron de 0.00±0.02 pH a pH 7.40, –2.5±1.5 mmHg PCO2 a PCO2 40 mmHg, y 3.3±1.3 mmHg PO2 a PO2 80 mmHg.相似文献
943.
Audrey Miller SRN RMN RTN BA MSc 《Journal of advanced nursing》1985,10(1):63-69
It is often assumed that nursing care is given in response to the patient's degree of incapacity. This study indicates that rather than nursing care arising as a response to patients' dependency, nursing care is producing dependency. A considerable proportion of the measured dependency of 168 elderly patients arose from the type of nursing care they received--it was iatrogenic. Task allocation nursing was found to be positively unhealthy for elderly long-stay patients, whilst individualized care (nursing process) was associated with lower patient dependency, a shorter hospital stay and a better chance of surviving the hospital stay. The findings demonstrate the inadequacy of nurse staffing formulas which are based on patient dependency. It is suggested that despite the rising numbers of very old people in the population, the elimination of nurse-induced dependency could reduce the level of dependency in geriatric wards. 相似文献
944.
945.
Reflection-on-practice: enhancing student learning 总被引:4,自引:0,他引:4
Gillian Richardson MSc RGN RHV Cert Ed Hendrika Maltby MScN BScN BA RN 《Journal of advanced nursing》1995,22(2):235-242
The writing of a reflective diary is viewed as an effective tool for promoting reflection and learning in students, and for self-assessment and evaluation of a clinical learning experience This work is a study of 30 undergraduate nurses and then- use of reflective diaries during a period of community health care practice The theoretical basis of the study is based on Schon's work on reflection-in-action The research tool, developed for the study of nursing practice by Powell, is based on Mezirow's levels of reflectivity The findings are that, in the sample used, students do reflect on their practice according to Mezirow's levels of reflectivity, but that the highest number of reflections occur at the lower levels of reflectivity (94% of the total number of scores) However, although only 6% of the total number of scores were found at the higher levels of reflectivity, some 22 of the sample of 30 students did attain conceptual and theoretical reflectivity, the highest levels of reflectivity 相似文献
946.
Adapting to change can often be a difficult process. How traditionally trained nurses perceive the change brought about by Project 2000 is important, since this may affect how they view their own future, how they receive those who are qualifying via Project 2000 and how they work with Project 2000 diplomates in the future. It is, therefore, important that attempts are made to overcome any resistance to the changes brought about by Project 2000. The findings presented here are taken from the first questionnaire in a Department of Health-funded, longitudinal study into the careers of traditionally trained mental health nurses. Five hundred and fifty-six nurses were asked their views about the new training and how they thought it would affect them. Four hundred and forty-seven people returned the questionnaire: an 80% response rate. This study has revealed some positive views on Project 2000 as well as a variety of concerns. 相似文献
947.
Dianne Stevens Rn Maree Johnson Rn MAppSci PhD Rachel Langdon BappSc BA 《International journal of nursing practice》2000,6(5):268-275
Two interventions: a forced warm-air device (Bair-Hugger series 500, Augustine Medical Inc., Eden Prairie, MN, USA), group 1; and a standardized approach to the use of warmed blankets (group 2) are compared with the aim of enhancing thermoregulation in surgical patients with mild and moderate hypothermia in the immediate recovery period. One hundred and twenty patients in a post-anaesthetic care unit were systematically allocated to group 1 or group 2 so each group consisted of 110 participants. No significant differences were found between the groups in gender, age, time in surgery, use of warmed intravenous fluids or muscle relaxants, or type of surgery. After exclusion of orthopaedic patients, significant differences in the mean rewarming rates were found, with more rapid rewarming occurring within group 1 (the group rewarmed with a forced warm-air device, t = 2.15, df = 92, P = 0.03) compared with group 2. No significant differences were found in the mean rewarming time, or heat gain between groups, and subsequent power estimates were less than 0.80. This study supports improved rewarming rates in select surgical patients (with mild or moderate hypothermia) using the Bair-HuggerTM compared with a standardized blanket rewarming intervention and identifies the need for patient comfort and cost-benefit analysis to be considered in future studies. 相似文献
948.
949.
Julie Santy RGN ENB BSc MSc Lynne Newton-Triggs RGN ENB BA MA 《Journal of Orthopaedic Nursing》2006,10(4):198-205
The management of sites for external fixator pins and wires has been a matter of debate within orthopaedic and trauma nursing for decades. The literature outlining the conundrum goes as far back as the early 1980s. Sadly, none of this literature, to date, has resolved the question of how to most effectively prevent infection in these challenging wounds. This article reports on a UK survey that identifies current practice in pin and wire site wound management. It should help those planning to conduct research in this area to identify possible interventions, controls and variables that need to be taken into account when conducting randomised controlled studies. 相似文献
950.