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A Newens

Publications and source records attributed to A Newens.

8 recordsLinked to original sources
PubMed1999

Hospital monitoring of pressure ulcers in the UK.

Hospital trusts and health authorities are increasingly being expected to report on numbers of patients with pressure ulcers. Although pressure ulcer audits should be undertaken in a systematic way, there are no agreed standards and little is known about the current status of pressure ulcer monitoring. A postal survey was conducted to establish a national picture of both assessment and audit of pressure ulcers. Questionnaires were sent to 276 acute hospital trusts throughout the UK; 204 were returned, giving a response rate of 74%. Fewer than half of the trusts (40%) employed a tissue viability nurse, and 28.5% of respondents were another type of clinical nurse specialist. Most hospitals used single scales for grading pressure ulcers and risk assessment but the frequency and method of such surveys varied considerably. Relatively few hospitals (5%) monitored the number of pressure ulcers on a daily basis, 30% made some form of weekly return and 22% made monthly returns. The authors conclude that there are national variations with respect to the pressure ulcer assessment tools used to provide audit data, and to the methodology and documentation used to collate data. A national consensus is recommended on auditing of pressure ulcers in the UK.

Hospitalization↗
PubMed1989

A comparison of human ultralente- and lente-based twice-daily injection regimens.

The problem of fasting hyperglycaemia remains unresolved on currently used twice-daily injection regimens. Human ultralente insulin is of longer duration than human lente and differs from it only in the nature of the zinc-insulin complex. In a 6-month double-blind crossover study these insulins were compared in 66 patients who were randomized to human ultralente or human lente insulin given together with human soluble insulin in a twice-daily injection regimen. Patients were seen monthly and crossed over after 3 months treatment. Fasting blood glucose concentrations on the ultralente regimen were considerably lower than on the lente regimen, the difference being statistically significant (6.6 +/- 0.5 vs 8.2 +/- 0.5 mmol l-1, p less than 0.05), but only present in those patients with fasting concentrations below the median. Glycosylated haemoglobin was identical on both regimens (9.3 +/- 0.2%). The evening ultralente dose was slightly but significantly lower than the evening lente dose (14.9 +/- 0.8 vs 15.5 +/- 0.8 U, p less than 0.05) thus endorsing the lowering effect of ultralente on the fasting blood glucose concentration. However, the incidence of serious hypoglycaemic events was higher on the ultralente regimen (0.38 +/- 0.10 vs 0.09 +/- 0.04 events per patient-month, p less than 0.02), the majority of nocturnal events occurring between 0500 h and breakfast. We conclude that ultralente insulin can give an improved fasting blood glucose concentration but that in those patients with more marked fasting hyperglycaemia or with a nocturnal hypoglycaemia problem it offers no clinical advantage over human lente insulin in a twice-daily injection regimen.

Adult↗
PubMed1989

Double-blind crossover trial of isophane (NPH)- and lente-based insulin regimens.

Isophane (NPH) and lente insulin preparations have been the basis of insulin-injection regimens for many decades but were never formally compared. After a 2-mo run-in period, 82 patients were randomized to NPH (Protaphane) or lente (Monotard) insulin preparations given together with Actrapid as a twice-daily injection regimen in a double-blind study. Patients were seen monthly and crossed over after 5 mo of treatment. Control as assessed by glycosylated hemoglobin (NPH 9.2 +/- 0.1%, lente 9.3 +/- 0.1%, mean +/- SE) and fructosamine (1.55 +/- 0.02 and 1.57 +/- 0.02 mM) concentrations was identical for the two regimens as were home-collected laboratory-measured fasting blood glucose (BG) (NPH 8.8 +/- 0.5 mM, lente 9.0 +/- 0.5 mM) and mean BG (8.2 +/- 0.3 and 7.6 +/- 0.3 mM) concentrations. For both regimens, the major control problem was the BG concentration before and after breakfast. Total insulin dosage was similar (NPH 56.3 +/- 0.6 U/day, lente 57.2 +/- 0.6 U/day) with no tendency for a difference in the evening intermediate-acting dose (NPH 17.0 +/- 0.3 U/day, lente 17.0 +/- 0.3 U/day) to counter fasting hyperglycemia. Serum lipid concentrations and body weight confirmed the equivalence of control. Hypoglycemic events were recorded in personal diaries and graded by predetermined criteria. Self-treated, relative-assisted, and hospital/doctor-treated hypoglycemic events did not differ in frequency. We conclude that lente- and NPH-based twice-daily human insulin regimens give indistinguishable metabolic control.

Adult↗
PubMedDate not supplied

The experience of women during their partners' hospital stay after MI.

Structured interviews were undertaken with 159 women following their partner's myocardial infarction (MI) and 129 of these women completed a further postal questionnaire approximately three weeks later. While in hospital, only a quarter of women were spoken to by nurses about possible dietary change for their partners, 24 percent were advised about exercise and 11 percent about work. Thirty one percent were spoken to about general lifestyle of their partners. When asked to rate the usefulness of information from all sources about various topics, those women who had been spoken to by nurses had significantly higher scores three weeks post-MI than women who had not. Nurses were frequently not proactive in offering information to women who showed high levels of anxiety and depression at both time points. These findings are discussed in relation to the role of hospital nurses in secondary prevention strategies.

Female↗
PubMedDate not supplied

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Health Services Administration↗