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Debbie Kralik RN MN MRCNA Tina Koch RN CNC BA PhD FRCNA Karen Wotton RN RM IW DipEd. BN M.Mgt. 《Journal of advanced nursing》1997,26(2):399-407
This study aimed to understand what post-operative patients perceived was important about the nursing care they had experienced. The participants were nine women recovering from total hip replacement surgery which had been performed in a large public, acute care hospital in south Australia. Participants volunteered to be involved in the study and were interviewed pre- and post-operatively and interviews continued in their home environment following discharge. The study took place during 1995 within a 10-month time frame. Methodological guidance was sought from the phenomenology literature, with the ideas from Husserl and Heideggar providing shape for the interpretive framework. The analysis of data utilized Colaizzi's (1978) seven procedural steps. For the purposes of this paper the authors have selected to focus only on the findings of this study. Two major themes emerged from the conversations with women. Patients described nurses as being engaged or detached with their nursing care. These themes will be explicated in this paper. In the light of these dominant themes the nursing literature around engagement and detachment are examined. The implications for nursing practice are discussed. 相似文献
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David J Read CSC MBBS MEpid FRACS Jessica Wong MBBS Hons MS MIPH FRACS Raine Liu MD Kellie Gumm CNC Med GradDipHIthProm CertICU DipNursing David Anderson MStJ BSc MBChB Dip PallMed FCICM 《ANZ journal of surgery》2023,93(7-8):1896-1900
Background
Prehospital tourniquets (PHTQ) for trauma have been shown to be safe and effective in the military environment and in some civilian settings. However, the supporting civilian data are mostly from North America with a differing case mix and trauma system and may not be applicable to the Australian environment. The aim of this study is to describe our initial experience with PHTQ from safety and efficacy viewpoints.Method
Retrospective review of all patients with PHTQ from 1 August 2016 to 31 December 2019 was conducted. Data were matched from the RMH Trauma Registry and Ambulance Victoria Registry. Clinical presentation including prehospital observations, PHTQ times, limb outcomes and complications are described.Results
Thirty-one cases met inclusion criteria, for whom median age was 37 (IQR: 23.9–66.3), median ISS 17 (13–34) and 80.6% were male. The majority (n = 19, 61.3%) were as a result of road traffic crash, and six (19.4%) from penetrating mechanisms, usually glass. Over a quarter (29.0%) suffered a traumatic amputation. The median prehospital SBP was 100 (IQR: 80–110), the median prehospital HR was 101 (IQR: 77.0–122.3) and was the median PHTQ time was 124 min (IQR: 47–243). Complications attributable to the tourniquet were seen in 4/30 cases (13.3%).Conclusion
This Australian series differs from North American civilian PHTQ series with a lower penetrating trauma rate and longer PHTQ times. Despite this, complication rates are within the published literature's range. Concerns regarding limited transferability of overseas studies to the Australian context suggests that ongoing audit is required. 相似文献4.
BACKGROUND: Clinical practices or procedures based on the best available evidence are an essential resource within an intensive care unit (ICU). Maintaining the currency of a local clinical practice manual is challenging however, particularly in relation to the time required, other workload pressures and the availability of staff with relevant skills to interrogate the literature. The aim of the Intensive Care Collaborative (ICC) project was to use the synergism of group processes to develop state-based clinical guidelines for six common intensive care practices - eye care, oral care, endotracheal tube management, suctioning, arterial line management, and central venous catheter (CVC) management. METHODS: Participants were 55 senior nurse clinicians from all nine area health services in NSW, seven academic facilitators, and staff from the Intensive Care Coordination and Monitoring Unit (ICCMU). A range of approaches were used to develop the six clinical practice guidelines (CPG) and related systematic literature reviews, including a preparatory educational seminar for participants, formation of working groups of clinicians, with subsequent teleconferences, e-mail and online forums to identify the scope of each guideline and review the literature. A consensus development conference (CDC) was conducted to finalise the reviews with a nominal group technique (NGT) used to develop recommendations for practice. External Validation Panels (EVP) verified the recommendations in each clinical practice guideline. Group voting was undertaken using a Likert scale (1-3 disagree, 4-6 neutral, 7-9 agree) with consensus agreement set as a median of at least seven. RESULTS: Eighty-three recommendations for practice were developed for the six Clinical Practice Guidelines; 50% were based on research literature evidence (23% with high levels of evidence). The balance were based on consensus opinion of the panel members. Only five recommendations were not validated by external validation. CONCLUSION: This project has demonstrated a method for guideline development that is robust, incorporating evidence from research and clinical expertise utilising an objective egalitarian framework. 相似文献
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Ismaila Emahi Mimmie CNC Watts Samuel Azibere Joseph F Morrison Kwabena AN Sarpong 《African health sciences》2021,21(4):1509
Corona virus disease 2019 (COVID-19) remains an incurable, progressive pneumonia-like illness characterized by fever, dry cough, fatigue, and headache during its early stages. COVID-19 has ultimately resulted in mortality in at least 2 million people worldwide. Millions of people globally have already been affected by this disease, and the numbers are expected to increase, perhaps until an effective cure or vaccine is identified.Although Africa was initially purported by the World Health Organization (WHO) to be severely hit by the pandemic, Africa recorded the least number of cases during the first wave, with lowest rates of infections, compared to Asia, Europe, and the Americas. This statistic might be attributed to the low testing capacity, existing public health awareness and lessons learnt during Ebola epidemic. Nonetheless, the relatively low rate of infection should be an opportunity for Africa to be better prepared to overcome this and future epidemics.In this paper, the authors provide insights into the dynamics and transmission of the severe acute respiratory syndrome corona virus (SARS-CoV-2) during the first wave of the pandemic; possible explanations into the relatively low rates of infection recorded in Africa; with recommendations for Africa to continue to fight Covid-19; and position itself to effectively manage future pandemics. 相似文献
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Jevan Cevik BBiomedSc MD David Read CSC MBBS MEpid FRACS Mark Putland MBBS FACEM GradCertEmergHealth GradCertClinResMeth MPH Timothy Fazio MBBS MIS FRACP FAIDH CHIA Kellie Gumm CNC MedGradDipHIthProm CertICU DipNursing Amrita Varma PhD GradDipClinRes Roselyn Santos Anand Ramakrishnan MBBS MD MPH FRACS 《ANZ journal of surgery》2024,94(4):572-579
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Developing a guideline for structured content and process in mental health nursing handover
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S. Raj Sundaraj MBBS FANZCA FFPMANZCA FIPP CIME ; Paul Ponciano MD ; Charlotte Johnstone MBBS FANZCA FFPMANZCA ; Faiz Noore MBBS FANZCP FFPMANZCA ; Maria Castro RN CNC 《Pain practice》2004,4(3):229-234
Abstract: Chronic refractory daily headache is a relatively common problem in the Australian population. Several million working hours per year are lost due to this illness. Generally not responding to conventional therapies. We treated 22 such patients diagnosed as severe refractory migraine and/or mixed tension headache at our multidisciplinary pain management center. Before inclusion to our study, they received maximal medical management, which included cognitive behavior therapy, but failed to respond. These patients received between 30 and 100 units of botulinum toxin type A. Our study showed 84% (19 of 22) achieved significant improvement in their pain complaint. There was significant reduction of medications particularly opioids. The duration of pain relief ranged from 1 to 6 months. Repeat injections were necessary in several of the patients. There were minor complications but these reversed spontaneously without further treatment. 相似文献
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Effect of secondary penicillin prophylaxis on valvular changes in patients with rheumatic heart disease in Far North Queensland
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