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B Gilchrist

Publications and source records attributed to B Gilchrist.

10 recordsLinked to original sources

The role of the nurse in the medical ward round.

Communication between hospital staff and in-patients, especially regarding the provision of information, has been found to be inadequate although improving information-giving has been demonstrated to have a number of beneficial effects. While the ward round might be a particularly valuable setting for communication, few studies have explored the multidisciplinary nature of rounds. This study obtained the views of 33 consultants, 14 nurses and eight patients and observed three ward rounds in order to determine the nature of present round functioning, and the nurse's role in such a round. The results showed that the rounds studied were not being conducted in a democratic fashion: medical staff dominated and other health care professionals had little involvement. Patients received few explanations and had great difficulty understanding the discussion. The functions nurses were seen to perform involved primarily providing information for medical staff. It is recommended that patients are more involved in rounds and are given more explanations and encouraged to ask questions. Nurses should be educated to assert themselves in ward rounds in order to fulfil roles they prescribe for themselves, and all professionals should aim towards more democratic, equal discussion. There is a need for further research to determine the effectiveness of nurse intervention on patient involvement and satisfaction with the round.

Assertiveness

The bacteriology of chronic venous ulcers treated with occlusive hydrocolloid dressings.

The bacterial flora of chronic venous ulcers treated with an occlusive hydrocolloid dressing were studied over a period of 8 weeks. A novel exudate sampling method was used in an attempt to isolate anaerobic bacteria. The flora was generally stable. Once a species was present, it remained with the exception of Pseudomonas, which appeared to be inhibited by the dressing. Twelve out of 20 ulcers contained anaerobic bacteria and healing did not appear to be impaired by the presence of any particular species of bacteria.

Aged

Chronic hyperdynamic sepsis in the rat: I. Characterization of the animal model.

We describe a new rat model of chronic hyperdynamic sepsis. After control values for weight gain, and food and water intake of each animal were obtained over a 5-day period, male Sprague-Dawley rats weighing 370-425 g were anesthetized, catheterized to allow chronic cardiac-output measurements, and a sterile subcutaneous cavity was formed over the flank area. The animals were allowed a 3-4 day postoperative recovery period. Body weight, food and water intake, and cardiac output were measured daily. Frequent blood samples were withdrawn for bacterial cultures and white cell counts (WBC). On the third and, in some cases, the fourth postoperative day, the subcutaneous cavity was inoculated with 10(9) colony-forming units of Escherichia coli and Bacteroides fragilis. The resulting sepsis was characterized by loss of body weight in spite of normal food and water intake, increased cardiac output, increased WBC, intermittent bacteremia, decreased muscle mass, and decreased cross-sectional area of skeletal muscle myofibrils. Two levels of septic response emerged--moderate and severe. Based on the above-mentioned measurements, it was possible to categorize all long-term septic animals into these two groups. Both groups exhibited cardiac-output, body-weight, and WBC data significantly different from sham controls. Repeated inoculations of the subcutaneous abscess initiated on the third postoperative day resulted in moderate sepsis with no long-term mortality, severe sepsis with 23% mortality over a 3-week period, or a 100% mortality within 4 days, depending on the virulence of the E. coli organisms used. The new model is ideally suited for pathophysiologic studies of sustained, hyperdynamic sepsis.

Animals

Writing the off-duty.

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Administrative Personnel