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Biomedical subjects

B Blaylock

Publications and source records attributed to B Blaylock.

At least 19 recordsLinked to original sources
PubMed1996

Case management: a new practice model for ET nurses.

An examination of wound, ostomy, and continence nursing practice provides ideas for improving patient care and for role development of the ET nurse. During this period of rapid health care reform, opportunities to expand ET nursing practice must be explored. For many ET nurses, care of the patient with an ostomy remains a primary focus. The fitting of prosthetic equipment and patient education concerning ostomy care may not, however, be enough to demonstrate the impact of ET nursing care on the outcome of patients with an ostomy. Caring for the patient undergoing gastrointestinal surgery by means of a case management model is a new option for ET nurses. Nurse case managers focus on the patient and the impact of illness from admission until discharge. They are accountable for coordinating the multidisciplinary team who cares for the patient and for the evaluation of outcomes. ET nurses must evaluate the outcomes of their care to demonstrate the continued need for our specialty practice. This article describes the efforts of ET nurses at a tertiary care center in the Midwest to develop a case management system for patients undergoing gastrointestinal surgery within their practice. The process of developing a critical pathway, or care map, is also described.

Case Management↗
PubMed1996

Solving the problem of pressure ulcers resulting from cervical collars.

Cervical orthotic devices (cervical collars) are integral to the treatment of patients with suspected or confirmed fracture of the cervical spine. Pressure ulcers can develop under the cervical collar on the occipital protuberance and on the chin due to both prolonged immobilization and the collar construction. A multidisciplinary team at a Northwest Ohio trauma center led an investigation of this problem when a one day study of pressure ulcer prevalence revealed that of 4% of nosocomial pressure ulcers, 2% were attributed to cervical collars. To solve this problem, the team visualized risk factors using a fishbone diagram, investigated by calling manufacturers and other institutions and by searching the literature, developed educational programs on skin care and correct collar fitting, conducted a product trial on a new collar, and continuously monitored the results. The conclusions of the team were that the pressure ulcers were the result of the construction of the previous cervical collars used. The product trial resulted in zero skin breakdown for the 20 patients involved. Changes implemented as a result were an improved skin care regimen, education on proper fitting and appropriate choice of collars, and implementation of the new collar for trauma patients.

Braces↗
PubMed1995

A study of risk factors in patients placed on specialty beds.

Air-fluidized and low-air loss beds have become common throughout the United States. Many studies have demonstrated the efficacy of these beds in the prevention and treatment of pressure ulcers. Determining which patients truly need this therapy and which could have positive outcomes with other pressure-relieving or pressure-reducing devices can be difficult. The purpose of this research was to examine medical diagnoses, total Braden Scale scores, Braden Scale subscores (sensory perception, moisture, activity, mobility, nutrition, and friction/shear), nutritional levels, and comorbid conditions among patients placed on specialty beds for prevention and treatment of pressure ulcers. A retrospective chart review of 47 patients who used specialty beds during an 18-month period was used to determine factors that were clinically significant.

Adult↗
PubMed1995

Latex allergies: overview, prevention and implications for nursing care.

Latex allergies are becoming increasingly common among healthcare workers and patients since the initiation of the use of universal precautions. Select groups of patients and professionals are at higher risk for this problem, such as workers in the rubber and healthcare industries, and persons with congenital urologic abnormalities, spina bifida, myelodysplasis and any other condition requiring frequent exposure of skin or mucous membranes to latex products. Specific interventions and alterations in standard procedure are required to prevent latex complications, such as compiling a list of products that contain latex and alternative latex-free products, screening for latex allergy upon admission, and creating a written policy to protect workers. A multidisciplinary approach is needed to investigate which products contain latex and to establish protocols for each department.

Humans↗
PubMed1994

Product evaluation and process improvement.

This article discusses how a systematic approach to product selection and evaluation can assist health care personnel. This model considers four tenets: (1) quality, (2) cost, (3) safety, and (4) practitioner choice. An algorithm is utilized to serve as a visual guide for the introduction, trial, and selection of equipment and products. In addition to considering the four tenets, the article discusses the value of an integrated team approach and the importance of involving the staff in the decisions.

Attitude of Health Personnel↗
PubMed1994

Measuring tissue interface pressures of two support surfaces used in the operating room.

Patients undergoing surgery are often overlooked for the prevention of pressure ulcers. Anesthetized patients are at very high risk for pressure injury due to forced immobility which occurs during surgery. This risk has been reported to be higher for patients undergoing vascular surgery. Few studies have been conducted which examine the tissue interface pressure of the conventional operating table pad and products available to reduce pressure for patients undergoing surgery. Several cases of pressure injury in patients undergoing vascular surgery led to this study.

Beds↗
PubMed1994

Maintaining effective pressure ulcer prevention programs.

Considered by many health care workers to be an inevitable problem of aging, pressure ulcers are in actuality preventable. The prevention of pressure ulcers is a quality outcome of care. Health care providers are held accountable for following national clinical practice guidelines designed to prevent pressure ulcers and minimize associated morbidity. The experience of one enterostomal therapy department in implementing and maintaining a successful pressure ulcer prevention program is described.

Education, Nursing, Continuing↗
PubMed1993

PNA lectin-based separation of thymocytes into mature and immature subpopulations: CD4-8- double negative cells display characteristics of PNAlo mature thymocytes.

Cortical (immature) thymocytes are widely reported to express intermediate to high levels of receptors for the lectin, peanut agglutinin (PNA). Light-scatter studies of murine fetal thymocytes stained with PNA or anti-mouse CD4 and CD8 monoclonal antibodies indicated, however, that the most immature CD4-8- (DN) thymocyte subpopulation binds levels of PNA commonly described as PNAlo. Evaluation of the PNA binding characteristics of fetal thymocytes negative for the CD8 antigen confirmed the existence of a major population (approximately 20% of total cells) of CD4-8- PNAlo fetal thymocytes. The majority of these DN thymocytes were subsequently found to bind sub-agglutinating levels of PNA, similar to mature CD4+ or CD8+ single positive (SP) thymocytes. Given this information, an immunomodulating compound (2,3,7,8-tetrachlorodibenzo-p-dioxin; TCDD) known to produce a maturational delay in murine thymocytes was tested for a possible concurrent effect on thymocyte PNA lectin binding. A TCDD-induced increase in DN thymocytes was found to be paralleled by an increase of equal magnitude in PNAlo thymocytes. Taken together, these data provide evidence that acquisition of the PNA receptor may be a maturational event occurring during the DN stage of thymocyte ontogeny. Further, these results suggest that separation of thymocytes into mature (medullary) and immature (cortical) subpopulations by PNA agglutination may result in contamination of medullary cells by the most immature (DN) subpopulation of thymocytes.

Animals↗
PubMed1993

Factors contributing to protein-calorie malnutrition in older adults.

Protein-calorie malnutrition, a common problem of older adults, is frequently overlooked by nurses. The physiologic changes of aging, as well as changes in living conditions and income, all contribute to the problem. Recognition of this problem by nursing staff can reduce many of the health problems which are exacerbated by or result from malnutrition in this patient population.

Age Factors↗
PubMed1990

Pressure ulcers: a review.

Pressure ulcers continue to be a major problem for the immobilized elderly person. Approximately 3% to 5% of hospitalized persons and up to 45% of those in long-term care facilities develop pressure ulcers. Etiological factors for pressure ulcers are discussed as well as other factors contributing to pressure ulcer formation.

Aged↗
PubMedDate not supplied

Tape injury in the patient with total hip replacement.

Patients undergoing total hip replacement surgery may experience edema around the incision related to intraoperative positioning and manipulation of the extremity, as well as general soft tissue damage. The edema may contribute to the impairment of skin integrity when tape is applied to secure postoperative dressings. This article describes how the problem of impaired skin integrity was identified and the process used to determine the contributing factors. The interventions used by three nursing specialty areas to correct the problem are also described.

Adhesives↗
PubMedDate not supplied

Comparative study of risk factors for skin breakdown with cervical orthotic devices: Philadelphia and Aspen.

PURPOSE: To compare risk factors for skin breakdown between Philadelphia and Aspen cervical collars. METHODS: Crossover design. Twenty healthy volunteers wore Philadelphia and Aspen cervical collars in random order. Occipital pressure, relative skin humidity, and skin temperature measured at 0 and 30 minutes. Paired t-tests compared changes between collars from 0 to 30 minutes. FINDINGS: Occipital pressure and skin temperature were not statistically different between collars. Relative skin humidity increased more in Philadelphia (29% +/- 17%) than Aspen (8% +/- 9%), p < 0.001. CONCLUSIONS: Aspen resulted in lower relative skin humidity.

Adult↗
PubMedDate not supplied

The aging immune system and common infections in elderly patients.

The number of elderly persons in the United States has increased to 12.5% of the population, and diseases affecting this age group have also risen. Infections of the respiratory, urinary, and integumentary systems, commonly seen in elderly patients, are a leading cause of death. Changes in the immune system cannot be prevented; however, nursing interventions may reduce the incidence of infection. An understanding of the changes in the immune system and careful nursing assessments may help the nurse to detect infections in elderly patients earlier.

Aged↗