Biomedical subjects

A Wayne Bruce

Publications and source records attributed to A Wayne Bruce.

7 recordsLinked to original sources

PubMed2006

Breezing up--an interdisciplinary health professions course for high school juniors and seniors and college freshmen.

Recruiting students into the health professions is an ever growing problem as young people are faced with many attractive options for career choices. At the same time, a rapidly growing elderly population will require more health professionals to maintain the health system. To address this recruitment issue an interdisciplinary health professions course delivered to high schools and college campuses in North Dakota via the Internet was developed at the University of North Dakota (UND) School of Medicine and Health Sciences (SMHS). The participating high schools embedded the course in the health professions curriculum and students were given the option of receiving college credit. The course features presentations by professionals representing 16 different health professions and were developed using a new software called Macromedia Breeze that allows for easy recording of PowerPoint audio presentations and imputing video content into the presentation. Blackboard was utilized for course management.

Career Choice↗

PubMed2003

Pyuria detection using a dipstick applied to urine in incontinence pads.

The purpose of this study was to determine whether pressing a dipstick into a pad within 2 hours of urine saturation detected pyuria as effectively as immersing a dipstick in a urine specimen. Sensitivity, specificity, and positive and negative predictive values indicated that results of the pad method were as effective as those of direct dipstick into clean-catch urine in detecting pyuria. In the elderly, sensitivity of the pad method was 100%, indicating this would be an effective method for initial assessment of pyuria.

Adolescent↗

PubMedDate not supplied

Urinary tract infections in the elderly: a survey of physicians and nurses.

The purpose of this study was to identify, in the presence of significant bacteriuria, the symptoms that determine and conditions that affect whether a physician will begin antibiotic treatment in the elderly; 2 physician groups were studied: geriatric physicians and family practice/internal medicine physicians. We also sought to compare these results to symptoms and conditions that determine nurses' decisions to begin assessment for urinary tract infections (UTIs) in this population. We also sought to determine the importance these 3 groups placed of monitoring asymptomatic bacteriuria for specific elderly patient populations. Quantitative questionnaires were sent to a convenience sample of 1900 physicians and nurses. Sixty-eight of the 300 geriatric physicians (23%), 113 of the 1000 family practice or internal medicine physicians (11%), and 192 of the 600 nurses (32%) returned surveys. Results showed differences between physician groups and nurses concerning whether cloudy and malodorous urine were symptoms of a UTI. This survey also found that physicians consider patient conditions to a greater extent than nurses do in their decisions regarding UTIs. Geriatric physicians appear to be less likely to monitor asymptomatic bacteriuria in any elderly patient population. Finally, we found that with regard to monitoring asymptomatic bacteriuria, both physician groups and the nurse group gave the greatest support for monitoring among elderly who have difficulty presenting symptoms of a UTI.

Aged↗

PubMedDate not supplied

The clinical laboratory improvement amendment: how it applies to the use of urine dipsticks in the long-term care facility.

The urine dipstick is one of the waived tests that is used in the long-term care facility under guidelines of the Clinical Laboratory Improvement Amendment (CLIA). Through recent surveys, the Centers for Medicare and Medicaid Services (CMS), which oversee this program, have identified significant problems in many testing sites. Because of the magnitude of the problem, the surveys will be continued. To comply with CLIA guidelines and safely and appropriately use the urine dipstick in the long-term care facility, nurses need to be aware of these guidelines. The purpose of this article is to discuss CLIA requirements regarding waived tests, specifically the urine dipstick, in the long-term care facility.

Aged↗

PubMedDate not supplied

Are true-negative nitrite results affected by a two-hour delay in dipstick/pad analysis of urine in incontinence pads?

OBJECTIVES: To determine if true-negative nitrite results of a urine dipstick pressed into an incontinence pad (dipstick/pad method) are affected by a 2-hour delay in analysis. DESIGN: A quantitative study. SETTING AND SUBJECTS: Clean-catch urine specimens from a convenience sample of clinic patients, staff, and long-term care facility residents. INSTRUMENT: Changes from negative to positive for each group of urine specimens were evaluated using percentages within the groups. METHODS: Urine specimens were collected and a portion was cultured. Urine specimens negative for a urinary tract infection were included in the study. A portion of the specimen was poured into an incontinence pad. Initial nitrite results were determined using a dipstick pressed into an incontinence pad. Pads with true-negative dipstick/pad nitrite results were tested 2 hours later in the same manner. Urine culture results determined groups: mixed colonies; 50,000 to 75,000 colony-forming units per milliliter of a single type of uropathogen; greater than or equal to 50,000 cfu/mL diphtheroids; no significant growth; and no growth. RESULTS: Of the 443 urine cultures negative for a urinary tract infection, 441 initial dipstick/pad nitrite results were negative. Two initial true-negative nitrite dipstick/pad results, or 0.5%, changed from negative to positive over the 2-hour period: 1 in the "mixed colonies" group (0.4%) and 1 in the "no growth" group (0.7%). CONCLUSIONS: Results of this study indicate that true-negative nitrite results of a dipstick pressed into urine in an incontinence pad do not appear to be affected by a 2-hour delay in analysis.

Adolescent↗

PubMedDate not supplied

A protocol for the urine dipstick/pad method.

The urinary tract accounts for nearly one third of all infections in the long-term care setting. This article reviews factors that influence nitrite and leukocyte esterase results obtained from traditional urine dipstick analysis for assessment of urinary tract infections in elderly long-term care residents. This article also proposes a protocol for a urine dipstick pressed into an incontinence pad as an alternative to dipstick analysis of a clean-catch or catheterized urine specimen.

Aged↗

PubMedDate not supplied

A survey regarding the use of the dipstick/pad method with elderly, incontinent patients.

OBJECTIVE: To determine if nurses and physicians would use the dipstick/pad method to test urine in elderly, incontinent patients with suspected urinary tract infection. DESIGN: A cross-sectional survey was sent to 1900 physicians and nurses. SETTING AND SUBJECTS: A convenience sample of nurses and geriatricians, family practice, and internal medicine physicians was obtained from lists on the Internet, a geriatric care conference, and a geriatric nursing journal mailing list. INSTRUMENTS: A 3-part questionnaire queried: (1) whether respondents would use the dipstick/pad method; (2) would they use results to initiate or monitor nonantibiotic interventions, antibiotic interventions, or determine further laboratory analysis; (3) would a particular combination of nitrite and leukocyte esterase results determine the need for further laboratory testing. Nurses were also asked if they had used results of dipstick urinalysis in their management of urinary tract infections. METHODS: The questionnaire was mailed to 300 geriatric physicians, 1000 internal medicine and family practice physicians, and 600 nurses. RESULTS: A total of 373 individuals (20%) responded to the survey. Sixty-five percent of the nurses responding had not used dipstick results; 90% of these nurses would consider using dipstick/pad results. Ninety-five percent of both the physician groups and the nurses who had previously used dipstick results indicated that they would consider using the dipstick/pad method. Determining the need for further laboratory analyses was the most accepted application by all groups. No combination of nitrite and leukocyte esterase dipstick results elicited greater than a 76% agreement by either physician group with regard to outcomes for further analyses. CONCLUSIONS: Although the response rate was low, the results of this survey suggest that healthcare workers would consider using the dipstick/pad method with incontinent elderly patients in the assessment of a urinary tract infection, primarily to determine further laboratory tests.

Aged↗