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Biomedical subjects

B Bates-Jensen

Publications and source records attributed to B Bates-Jensen.

11 recordsLinked to original sources
PubMed2001

Algorithms, critical pathways, and computer software for wound care: contemporary status and future potential.

The contemporary use of algorithms, critical pathways, and computer software significantly affects all aspects of healthcare treatment from primary care to acute trauma management. Guidelines and heuristic devices specific to chronic wound care have been introduced to assist with quality implementation and monitoring of outcomes in a cost-conscious American healthcare system. Some wound care algorithms and critical pathways even have been computerized. This article discusses the differences among the various forms of wound care heuristic methods, describes their advantages and disadvantages, and suggests how they can be successfully implemented in clinical practice settings. Directions for future research also are offered.

Algorithms↗
PubMed1998

Senior centers. Shifting student paradigms.

The purpose of this study was to evaluate an innovative service learning experience for new nursing students involving senior citizen centers. Junior nursing students (n = 128) were assigned in cohorts to one of five centers for a 5-week rotation. A questionnaire was administered post hoc to the students, teaching assistants, center directors, and a sample of senior citizens at each site. The majority of students believed the experience was a valuable part of the curriculum and saw prospects for community health nursing roles. However, they had concerns regarding losing time in acute care and relevance and number of assignments, and reported some difficulty in applying classroom content in the setting. Directors and senior citizens were universally positive about the experience. Student and teaching assistant reports were key in revising the curriculum. Revisions include logistics of the placement of the experience and assignments as well as incorporation of this experience within the community context.

Adolescent↗
PubMed1995

Predictors of successful prompted voiding among incontinent nursing home residents.

OBJECTIVE: To develop a simple, noninvasive assessment strategy that will enable nursing home staff to identify incontinent residents who respond well to prompted voiding. DESIGN: Incontinent nursing home residents underwent an extensive clinical and functional assessment and then 7 days of prompted voiding. Data from the assessment and the first 3 days of prompted voiding were used to predict responsiveness to the intervention. SETTING: Seven nursing homes. PATIENTS: A cohort of 191 incontinent, long-stay nursing home residents who passed a simple behavioral screen (able to state their name or reliably point to one of two named objects). INTERVENTION: Prompted voiding was carried out by trained research nurse's aides from 7 AM to 7 PM for 7 days. The intervention was maintained in responsive residents 5 days per week for an additional 9 weeks. MAIN OUTCOME MEASURES: Physical checks for wetness were done by research staff hourly from 7 AM to 7 PM for 3 days in a baseline condition, during days 5 through 7 of the 7-day prompted voiding intervention, and for 3 days at the end of 9 weeks of prompted voiding in the responsive group. Outcome measures were percentage of checks wet and response to prompted voiding, with "responders" defined as residents with an average of one or fewer wet episode per day on days 5 through 7 of prompted voiding. RESULTS: Seventy-eight (41%) of the residents were responders. Their wet percentage went from 26.7% to 6.4% at the end of 1 week and was maintained at 9.6% after 9 weeks of prompted voiding. The best predictors of responsiveness were the wet percentage and the appropriate toileting percentage during the first 3 days of prompted voiding, the self-care subscale score of the Multidimensional Observational Scale for the Elderly, and the ability to ambulate without human assistance. The best sensitivity and specificity in identifying responders was achieved when either the wet percentage was lower than 20% or the appropriate toileting percentage was higher than 66% during the first 3 days of prompted voiding (sensitivity, 87%; specificity, 69%). Those residents falsely identified as responders by these criteria still had a 46% relative reduction in wetness. CONCLUSIONS: A substantial proportion of nursing home residents respond well to prompted voiding. The most responsive residents can be easily identified using data collected during a 3-day trial of the intervention. The assessment strategy is consistent with federal guidelines and could be used to facilitate quality control by assessing changes in percentage of wetness from the expected norm.

Activities of Daily Living↗
PubMed1994

Use of a portable ultrasound device to measure post-void residual volume among incontinent nursing home residents.

OBJECTIVE: To determine the accuracy of a portable ultrasound device for the assessment of post-void residual (PVR) volume among incontinent nursing home (NH) residents. DESIGN: Prospective, clinical series. SETTING: Seven community-based nursing homes. STUDY POPULATION: Two hundred one consecutively assessed incontinent NH residents who were participating in a larger clinical trial. MEASUREMENTS: PVR volumes measured by trained research associates using a portable ultrasound device and by in-and-out catheterization were compared. The accuracy of the ultrasound was calculated using the volume obtained by catheterization as the gold standard. RESULTS: The ultrasound demonstrated excellent test-retest and interrater reliability. For low PVRs, the device was highly sensitive (.90) for PVR < 50 mL and .95 for PVR < 100 mL) and moderately specific (.71 for PVR < 50 mL and .63 for PVR < 100 mL). For PVRs of more than 200 mL (n = 26), the ultrasound had a sensitivity of .69 and a specificity of .99. CONCLUSION: The portable ultrasound we used was reliable and reasonably accurate for assessing PVR in a representative sample of incontinent NH residents. Because the sensitivity for clinically significant urinary retention (PVR > 200 mL) was only .69, repeated measurements may be necessary to exclude high PVR in individual NH residents. Recent changes in ultrasound design should improve its ease of use and accuracy. Although measuring PVR by ultrasound is much easier and more comfortable than catheterization for both NH residents and staff, the cost of the device may be a barrier to its widespread use in the NH setting.

Aged↗
PubMed1993

The dark side of incontinence: nighttime incontinence in nursing home residents.

OBJECTIVE: To describe the characteristics of nighttime urinary incontinence in a sample of nursing home (NH) residents. DESIGN: Prospective descriptive study of a convenience sample of incontinent NH residents. SETTING: Four NHs. PARTICIPANTS: 136 incontinent NH residents. MEASUREMENTS: Frequency and volume of incontinent and continent voids for three 10-hour daytime and three 10-hour nighttime data collection periods. RESULTS: The frequency of nighttime incontinence was the same as during the day, but the volume of nighttime incontinent voids and total nighttime volume were higher than during the day. There was substantial between- and within-subject variability in volumes, but the distribution of ratios of night/total volumes approximated a normal curve. Diuretic use was associated with relatively low nighttime volumes. CONCLUSION: About one-quarter of the NH residents we studied produced substantially more urine at night than during the day. Several medical, behavioral, and environmental approaches should be considered for reducing the frequency and volume of nighttime incontinence in this population.

Aged↗
PubMed1989

Psychological response to illness: exploring two reactions to ostomy surgery.

This paper has discussed two psychological responses to ostomy surgery, denial and personal control, both of which can be maladaptive in situations faced by ostomy patients. Nursing interventions for each response were suggested and discussed in relation to two case studies. It is hoped the the information presented will be useful to nurses dealing with persons undergoing ostomy surgery and experiencing maladaptive behavior.

Adaptation, Psychological↗
PubMedDate not supplied

The Wound Intelligence System: early issues and findings from multi-site tests.

The purpose of this manuscript is to address a gap in our efforts to incrementally improve wound care practice through evidence-based practice. The Pressure Sore Status Tool (PSST) provides data to extend evidence-based practice beyond clinical trials and into the clinical area itself. The computerized PSST was evaluated over one year through over 70 beta sites. Two studies which were part of that evaluation period are described which give a comparative analysis of wound stage and PSST scores, and similarities and differences in wound characteristics of four types of wounds: arterial/ischemic ulcers, neuropathic ulcers, pressure ulcers, and venous ulcers. In the first study, a relationship between PSST scores and staging scores for the presenting wound was present, indicating promise for the utilization of the PSST as an alternative to staging scores for describing changes in wound status. However, in the second study, clear difference was not noticeable between the four wound types, suggesting that discriminations regarding wound type may not be able to be made from PSST assessments. The goal of these studies was to provide feedback on the use of the computerized PSST, thereby providing feedback based on objective outcomes of the practice of clinicians themselves.

Education, Nursing, Continuing↗