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Biomedical subjects

A W Keeling

Publications and source records attributed to A W Keeling.

9 recordsLinked to original sources
PubMed2000

Reducing time in bed after percutaneous transluminal coronary angioplasty (TIBS III).

BACKGROUND: This study is the third in a series of investigations on the requisite length of time that patients should be restricted to bed after coronary arteriography or percutaneous transluminal coronary angioplasty using a femoral artery approach. METHODS: A prospective, experimental-control group design with randomization was used initially to compare the incidence of bleeding between patients who remained in bed for 4 hours and patients who remained in bed for 6 hours after sheath removal following percutaneous transluminal coronary angioplasty. RESULTS: Rapid changes in the healthcare environment led to nurses collecting complete data sets for the experimental group only. The experimental group (n = 51) was 73% male and 27% female; mean age was 57 years (SD = 11.4 years). Mean time in bed was 4.1 hours (SD = 0.27 hours). Most patients (98%) did not bleed from the femoral artery access site after remaining in bed for 4 hours following sheath removal. Ninety-two percent of patients required analgesics while in bed. Mean length of stay after the angioplasty was 1.4 days (SD = 0.79 days). Bleeding occurred in one subject and was related to multiple invasive procedures and an activated clotting time of greater than 200 seconds. CONCLUSIONS: Requisite time in bed after percutaneous transluminal coronary angioplasty has been reduced to 4 hours at the University of Virginia Medical Center, the same time required for patients undergoing cardiac catheterization. Discomfort after the procedure remains to be addressed.

Angioplasty, Balloon, Coronary↗
PubMed1994

Postcardiac catheterization time-in-bed study: enhancing patient comfort through nursing research.

Cardiac catheterization has become a routine diagnostic procedure. Little has been written about standards for nursing care related to bed rest postcatheterization. The purpose of this experimental study was to determine whether there was a significant difference in incidence of bleeding from catheter insertion site between those patients who remained in bed for 12 hours and those who remained in bed for 6 hours post-procedure. There was no significant difference between the two groups. Postprocedure bed rest was reduced from 12 to 6 hours in this tertiary care medical center. Decreasing time in bed reduced cost and patient discomfort.

Adult↗
PubMed1989

Clinical support for eliminating the nursing diagnosis of knowledge deficit.

An investigation of the appropriateness of the use of the nursing diagnosis, Knowledge Deficit, in specific clinical instances and examination of the diagnosis in light of validation criteria provided clinical support for eliminating it. The authors conclude that Knowledge Deficit falls outside of the boundaries of the discipline and that the label encourages nurses to focus attention on the promotion of knowledge as an entity rather than addressing a behavior related to the patients' lack of information. Removal of Knowledge Deficit from The North American Nursing Diagnosis Association (1986) taxonomy would force nurses to use other diagnostic labels.

Adult↗
PubMedDate not supplied

Nurse-initiated telephone follow-up after acute myocardial infarction: a pilot study.

OBJECTIVES: To determine the receptivity of patients with acute myocardial infarction and their spouses to postdischarge follow-up telephone calls from a nurse, and to describe the content of nurse-patient/spouse telephone conversation during early convalescence at home. DESIGN: Descriptive pilot study using qualitative methods. SETTING: University medical center and home. SAMPLE: Twenty-one male patients with acute myocardial infarction and their wives who agreed to participate in the study. RESULTS: All subjects were receptive to telephone follow-up by cardiac nurse clinicians. From data analysis of telephone calls, five content themes emerged. These included (1) difficulty accepting changed health status, (2) reports of attempts at risk factor reduction, (3) concern for financial difficulties, (4) dealing with uncertainty, and (5) expression of appreciation for the nurse-initiated telephone call. Nurse investigators provided information and emotional support and made referrals. CONCLUSIONS: Further research should be done to test the feasibility and effectiveness of nurse-initiated telephone follow-up after hospital discharge for acute myocardial infarction in reducing patient and spouse stress and increasing patient/spouse information about self-care regimens. The clinical trial should also determine whether telephone follow-up by nurse increases patient satisfaction with the health care delivery system.

Adult↗