Strategies to Avoid Neonatal Blood Transfusions for Families of the Jehovah’s Witness Faith

Beliefs and restrictions regarding acceptance of blood products by members of the Jehovah’s Witness faith often provoke discussion among health care professionals regarding alternative interventions. Establishing and maintaining an open dialog with women and families of the Jehovah’s Witness faith regarding their beliefs on the use of blood and blood products are vital in creating a therapeutic relationship between families and the health care team. Such rapport facilitates the discussion of strategies to avoid blood transfusions for newborns and provides women and families multiple opportunities to develop of a holistic birth plan congruent with their beliefs.     

Effect of high-frequency alternating current transcutaneous stimulation over muscle strength: a controlled pilot study

Background

High-frequency alternating currents of greater than 1 kHz applied on peripheral nerves has been used in animal studies to produce a motor nerve block. It has been evidenced that frequencies higher than 5 kHz are necessary to produce a complete peripheral nerve block in primates, whose nerve thickness is more similar to humans. The aim of the study was to determine the effect on muscle strength after the application of a high-frequency stimulation at 5 and 10 kHz compared to sham stimulation in healthy volunteers.

Findings

Transcutaneous stimulation at 5 kHz, 10 kHz and sham stimulation were applied to eleven healthy volunteers over the ulnar and median nerves for 20 min. Maximal handgrip strength was measured before, during, immediately after the intervention, and 10 min after the end of intervention. The 10 kHz stimulation showed a lower handgrip strength during the intervention (28.1 N, SEM 3.9) when compared to 5 kHz (31.1 N, SEM 3.6; p?<?0.001) and to sham stimulation (33.7 N, SEM 3.9; p?<?0.001). Furthermore, only stimulation at 10 kHz decreased handgrip strength when compared to baseline.

Conclusions

These findings suggest high-frequency stimulation has an inhibitory effect over muscle strength. Future studies are required in patients that are characterized by motor hyperactive such as spasticity or tremors.

Clinical trial registration

NCT, NCT03169049. Registered on 30 May 2017

     

Evaluación del triaje realizado por enfermeras en el Servicio de Urgencias del Hospital Clínico Universitario «Lozano Blesa» (Zaragoza)

Objective

To evaluate nurses’ triage quality and adequacy in Saragossa's Hospital Clínico and to compare the main characteristics of “urgent” and “non-urgent” visits to the Hospital Emergency Department (HED).

Cribado de retinopatía diabética mediante retinografía no midriática: concordancia de médicos de familia,enfermeras y oftalmólogos

Aim

To compare the evaluation of retinographies by a teleophthalmology nurse and primary care physicians (PCP) with an ophthalmologist referral hospital (gold standard).

Rol de enfermería en los programas de recuperación intensificada (fast-track)

Rapid recovery (RR) or fast-track programmes are aimed at reducing surgical stress, leading to a reduction in nurse workload, costs and hospital stay, greater patient empowerment, early post-surgical recovery and reduced morbidity and mortality. These new protocols require the coordinated participation of a multidisciplinary team.Based on an integrative review of the literature, this paper aims to define the concept of a RR or fast track programme and show the existing evidence on the implementation of these programmes in nursing.The benefits and low incidence of damage of RR programmes in nursing justify their implementation. The programmes require greater support and diffusion in order to develop, as well as more research to increase the evidence on the effectiveness and efficiency of the protocols.