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Biomedical subjects

B Pieper

Publications and source records attributed to B Pieper.

At least 37 records · Page 2Linked to original sources
PubMed1998

Pain associated with venous ulcers in injecting drug users.

Pain is a concern among people with venous ulcers. Although the prevalence is unknown, venous ulcers occur in those who have a history of illicit injecting drug use. The purpose of this study was to (a) examine the relationship between venous ulcer characteristics and pain severity, (b) ascertain factors that cause pain, (c) determine methods to alleviate pain, and (d) explore beliefs about pain medications among people with a history of injection drug use. Thirty-two patients answered pain and demographic questionnaires and had their venous ulcers traced onto plastic to identify wound area. Greater current pain, worse pain in 24 hours, and higher levels of pain relief from medications were significantly related to larger wound areas. Ibuprofen, compression dressing Unna's boot, and heroin ranked highest in decreasing pain. The most painful activities were working, walking outside, standing, and stair climbing. Many patients (41%) did not like to bother others with their complaints of pain. Participants were generally satisfied with pain treatments and the response of care providers to their pain. People who have used injected drugs and have venous ulcers do have pain. Therefore, research must continue to evaluate this pain as well as the best ways to treat it.

Adult↗
PubMed1997

Presence of pressure ulcer prevention methods used among patients considered at risk versus those considered not at risk.

PURPOSE: This study examined pressure ulcer-prevention strategies available for patients considered at risk versus those considered not at risk. DESIGN: The study used a prospective, longitudinal design. SETTING AND SUBJECTS: Six hundred ninety-four patients from units of five acute care hospitals, a rehabilitation facility, and two nurses' home care caseloads participated in the investigation. INSTRUMENTS: Data-collection instruments included the Braden Scale for risk assessment, demographic information, and the Pressure Ulcer-Prevention Strategies tool, which assessed for the presence of 16 pressure ulcer-prevention strategies. METHODS: All patients admitted to a participating unit during a 2-month period were followed up until discharge. Depending on the site, patients were assessed for the presence of pressure ulcer-prevention strategies one to three times per week. RESULTS: Patients in the at-risk group versus those in the not-at-risk group were more likely (p < 0.01) to have the head of the bed in a low position, a pressure-reducing bed surface, pressure ulcer prevention charted, a positioning wedge, incontinence cleanser and ointment, heel protection, a prevention care plan, a trapeze, and a posted turning schedule. The at-risk group had significantly (p < 0.01) more prevention strategies present than did the not-at-risk group. However, the percentage of patients placed on a pressure ulcer-prevention program was low for both groups. CONCLUSIONS: Pressure ulcer prevention was evident for the at-risk group, but at a low rate. Institutions must continue to explore this critical area affecting patient outcomes.

Aged↗
PubMed1997

Critical care nurses' knowledge of pressure ulcer prevention, staging and description.

The purpose of this study was to ascertain critical care nurses' knowledge of pressure ulcer prevention, staging, and description in reference to the AHCPR guideline on pressure ulcer prediction and prevention. A cross-sectional survey design was used to collect data from 75 critical care nurses. The Pressure Ulcer Knowledge Test, used to assess nurses' knowledge, consisted of 47 true/false items and had a total alpha reliability of.91. Items were sorted into subscores of Prevention (33 items), Staging (7 items), and Wound (7 items). The percentage of items answered correctly on the test by critical care nurses ranged from 15 percent to 83 percent. Test scores were not affected by years of nursing experience, type of nursing education, or when the nurses had last read an article about pressure ulcers. Only the Wound subscore was significantly affected by the time since listening to a pressure ulcer lecture. Few critical care nurses had read the AHCPR guideline on pressure ulcer prevention. This study revealed a knowledge deficit about pressure ulcer prevention among critical care nurses. Since pressure ulcers have been identified as a national health concern, information about their prevention must be shared and implemented in patient care.

Adult↗
PubMed1997

Occurrence of skin lesions/conditions in ill persons.

The purpose of this study was to examine the occurrence of common skin lesions that potentially may be misdiagnosed as a pressure ulcer, and to examine the characteristics of ill persons who have these skin changes. This was a prospective, descriptive study which included five acute care hospitals, a rehabilitation hospital, and a home care agency. Results indicated that patients with skin lesions/conditions were significantly older and had longer lengths of stay, more diseases, lower Braden Scale scores, and lower serum albumin levels. Nurses must gain knowledge about identifying and treating skin conditions. Assessment of the patient's skin should occur throughout their length of stay.

Age Distribution↗
PubMed1997

Pressure ulcer prevention within 72 hours of admission in a rehabilitation setting.

This prospective study followed 91 patients in an acute rehabilitation facility from admission until discharge. Of these patients, 35 patients were initially assessed at-risk for pressure ulcers. Demographics, risk status, and pressure ulcer prevention strategies were examined and assessed for at-risk and not at-risk patients. At-risk patients had significantly more medical diagnoses and longer hospitalizations than not at-risk patients, but did not differ by sex, race or age. The following pressure ulcer prevention strategies were considered for both at-risk and not at-risk patients within the first three days of admission: pressure-reducing bed surface, pillows for positioning, lift sheet, heel protection, posted turning schedule, pressure ulcer prevention care plan, pressure ulcer prevention charted, and pressure ulcer prevention educational materials at the bedside. Only the use of pillows for positioning was significant between the two groups; all other preventive strategies were comparable between both groups. For at-risk patients, it is necessary to implement pressure ulcer prevention strategies as early as possible after admission since pressure ulcers may quickly develop.

Adult↗
PubMed1996

Physical effects of heroin and cocaine: considerations for a wound care service.

Use of illicit substance is a major health care problem in the United States. Two commonly used illicit substances are heroin and cocaine. Both drugs can have multiple effects on the body, including the development of wounds. This article explores the street terminology, methods of use, and physical effects of heroin and cocaine, psychophysical nursing diagnoses and problems associated with their use, and considerations for a wound care service for persons with a history of heroin or cocaine use.

Cocaine↗
PubMed1996

A retrospective analysis of venous ulcer healing in current and former users of injected drugs.

PURPOSE: This study examined persons with a history of heroin injection who sought wound care for lower extremity venous ulcers and explored factors that affected their wound healing. METHODS: Descriptive, retrospective data were obtained by review of the medical records of an outpatient, urban clinic. An instrument was developed to record demographic, health, and illicit substance use information from the record. SUBJECTS: One hundred forty men and 32 women, 160 of whom were black, 12 of whom were white, seen in a wound care clinic in an urban medical center were included in the study. PRIMARY OUTCOME VARIABLES: Healing of venous ulcers present at the time care was sought, coexisting alcohol and tobacco use, and coexisting medical and mental health diagnoses. RESULTS: Persons who sought care tended to be middle-aged men with multiple health problems and a long history of illicit drug use. Persons whose leg ulcers healed had significantly smaller leg ulcers than did persons currently in treatment or not available for follow-up. CONCLUSIONS: Health care providers must be aware of the risk of venous insufficiency in current and former users of injected drugs and assess for venous insufficiency and venous ulcers. Users of injected drugs should be encouraged to seek professional wound care when ulcers are small, rather than attempting self-treatment.

Adult↗
PubMed1996

Predischarge and postdischarge concerns of persons with an ostomy.

This study examined the concerns of persons with ostomies before and after discharge from the hospital and attempted to determine whether these concerns were affected by the reason for stoma construction, temporary versus permanent status of the stoma, or the person's sex. Participants (N = 67) responded to a 46-item questionnaire titled "Perceived Effect of an Ostomy." Eight of the 46 items were common concerns affecting patients before and after discharge. These were fear of stool leakage, odor, ability to participate in sports, necessity for further treatment, wearing a pouch, changing the pouch, change in body appearance, and participating in sexual love play and intercourse. The total concern scores did not differ significantly with reason for stoma construction or temporary versus permanent ostomy status. Women had significantly higher concern scores than did men. Interviewing patients before and after discharge regarding their concerns may help to focus ostomy teaching and counseling.

Activities of Daily Living↗
PubMed1996

Comparing adjustment to an ostomy for three groups.

Three groups of persons with fecal ostomies (those with permanent ostomies as a result of disease (n = 13), those with temporary ostomies as a result of disease (n = 16), and those with temporary ostomies as a result of trauma (n = 18) were interviewed with various instruments to explore the psychosocial impact of an ostomy. The three groups did not differ significantly with respect to their scores on the Psychosocial Adjustment to Illness Scale, the Reintegration to Normal Living Index, or the Meaning in Life Scale. Those with a temporary ostomy as result of trauma had significantly higher Escape-Avoidance, Positive Reappraisal, Accepting Responsibility, and Planful Problem Solving subscores on the Ways of Coping instrument. The differences in coping scores may relate to adjustment to the violent act at the same time as the ostomy. These observations add to ostomy research because research about persons with temporary ostomies, especially those caused by a gunshot injury, is scarce.

Adaptation, Psychological↗
PubMed1996

Who is being missed in ostomy research?

This article compares persons who were included in a research study about living with an ostomy with those who were not included. Persons not included were those who were too physically ill to be independent in care, persons with paralysis, and persons with mental illness. Research about persons with ostomies should include an ethnically diverse sample, deal with caregiver and home care needs, and investigate special populations such as those in psychiatric units, rehabilitation units, or long-term care facilities. ET nurses are challenged to participate in more ostomy-related research.

Activities of Daily Living↗
PubMed1995

[Lactones. 28. EPC-synthesis, structure and pharmacology of "lactonized" and "lactamized" analogues of acetylcholine].

The enantiopure gamma-aminomethyl-gamma-butyrolactones (S)- and (R)-4a-d represent constrained analogues of acetylcholine, which were synthesized from D- or L-glutamic acid following two different routes. In addition, the corresponding lactames (S)- and (R)-10 were prepared by enantioselective synthesis. Only moderate activity was found at acetylcholine sites at the guinea pig atrium.

Acetylcholine↗
PubMed1994

A research primer.

Research is critical for the continued development of ET nursing knowledge. Although ET nurses have an interest in research, some may lack understanding of basic terms used in quantitative research. This article is a research primer that focuses on basic information about the research process. Information is presented about a study's purpose, literature review, conceptual framework, questions or hypotheses, instruments, design, sample, and statistics. The reader participates in the process by answering questions placed throughout the article.

Data Interpretation, Statistical↗
PubMed1993

Blood glucose monitoring at triage.

OBJECTIVE: To examine the use of a blood glucose monitor (BGM) on nursing and medical care, treatment time, and disposition time for patients in an ED triage. DESIGN: Experimental design. Individuals assigned to the experimental group had their blood glucose tested by finger stick in the triage area. The blood glucose level was made known to the triage nurse and/or the nurse caring for the patient in the emergency department proper. The investigator observed the nursing care, nursing and medical interventions and times. The control group underwent triage as usual, with no finger stick. SUBJECTS: Individuals with a history of diabetes and at least 18 years old were randomly assigned to the experimental or control group. The participants were 30 men and 38 women. RESULTS: Early knowledge of the patient's blood glucose level as determined by BGM affected time and implementation of nursing care. Three nursing interventions were significantly different between the groups: assessment, chi 2(1,N = 68) = 10.15, p < 0.001; consult a physician, chi 2(1,N = 68) = 17.58, p < 0.001; and order stat laboratory tests, chi 2(1,N = 68) = 13.09 = p < 0.001. The time the nurse intervened was significantly less for the experimental (24 minutes) than for the control (164.3 minutes) group (t[65] = -7.05, p < 0.001). Medical treatment time was significantly less for the experimental group (89.2 minutes) than for the control group (165.5 minutes) t[64] = -2.07, p = 0.05). Disposition time did not differ between groups. CONCLUSIONS: Data support the use of a BGM as a fast, accurate means of obtaining blood glucose levels. The nurses consulted with a physician, ordered stat laboratory tests for verification, and assessed the experimental patients more frequently than the control patients. Medical treatment time was also shorter for the experimental group. A BGM is an important source of data with which emergency nurses initiate care, at a fraction (3%) of conventional laboratory cost.

Adolescent↗
PubMed1990

Impact of cardiac transplantation on the spouse's life.

The purpose of this research was to explore the effect of waiting for heart transplantation and the effect of the transplantation on the life, relationship, and reported stress of the patient's spouse. A cross-sectional descriptive design was used. The impact of both the pretransplant (waiting) and posttransplant periods was measured by using the Perception of Heart Transplantation Questionnaire (PHTQ) and the Subjective Stress Scale (SSS). Thirty spouses of patients who had undergone cardiac transplantation completed the mailed questionnaires. Results indicated that spouses perceived the pretransplant period to have a greater overall influence on their lives and relationships (p less than 0.001) than did the posttransplant period. Their impression of the posttransplant period was significantly more positive than of the pretransplant period (p less than 0.001). However, no significant differences between pretransplant and posttransplant stress scores were found. These results demonstrate the great impact of the waiting period on the spouse's quality of life. Additional research is needed.

Adult↗
PubMed1990

Nurses' documentation about pressure ulcers.

Documentation in a patient's medical record is a nurse's legal and professional responsibility. Descriptive charting about pressure ulcers is critical since it may affect treatment modalities. The purpose of this research was to examine what nurses chart about pressure ulcers. The IAET Standards of Care Dermal Wounds: Pressure Ulcers (1987) was used as a guide. Nursing notes from 167 medical records were examined. None of the nurses' notations contained 100 percent of the items examined in this study. The most frequently occurring descriptor was location (74.2%). This research documents deficiencies in nurses' charting about pressure ulcers.

Aged↗
PubMed1989

[The value of knee joint orthoses in performance sports].

Commercial limited-motion braces are now being propagated both for prophylaxis and treatment of traumatic knee instabilities. This article presents a general classification of braces used in sports medicine and discusses their effectiveness and indication criteria.

Athletic Injuries↗
PubMed1989

Perioperative blood glucose levels. A study to determine the effect of surgery.

Blood glucose monitoring may be a crucial, additional role for the circulating nurse. Blood glucose levels can be determined quickly and easily by using a puncture device and reagent pads. Blood glucose meters vary from $130 to $480 and have been reported to be reliable. These monitors decrease the need for additional people in the operative environment to take specimens, thus decreasing the microorganisms in the room from additional personnel and movement. The blood glucose value may determine when additional insulin is needed, thus enhancing the diabetic physiologic state during the surgical experience. Blood glucose monitoring in the operative environment may help the surgical team maintain safe blood glucose levels for the patient with diabetes and prevent postoperative fluid and electrolyte abnormalities. Intraoperative blood glucose monitoring by the circulating nurse has the potential to enhance the physiologic environment, health, and possible early discharge of the person with diabetes.

Adult↗