Biomedical subjects

C A Beckmann

Publications and source records attributed to C A Beckmann.

14 recordsLinked to original sources

PubMed1998

Resident continuity clinics: a learning design for group private practice.

Continuity clinics are required for residents in obstetrics and gynecology in the U.S., but are costly and difficult to administer. Organizing them into group resident continuity clinic programs which emulate the group private practice most residents will join, creates a design that is parsimonious of clinic resources, while providing a type of continuity with which patients, nurses, and physicians are familiar and comfortable.

Continuity of Patient Care↗

PubMed1997

Self-reported factors influencing condom use among clinic attendees.

Data were collected from a convenience sample of 231 urban women seeking health care at a Midwestern women's health care center at a city medical center. Participants responded to 53 items, most taken from the Family Health Center Survey, which was designed to elicit descriptive data related to three major categories: background factors, factors that might influence the decision to use a condom, and knowledge and attitudes that might predict condom acquisition. Knowledge of HIV transmission and safer sex was not a predictor of condom use. Through education and demonstrations of proper condom usage, nurses and other health care providers were influential in persuading adolescents and young adults to use condoms.

Adult↗

PubMed1997

Use of neonatal boundaries to improve outcomes.

Technological advances have dramatically improved survival rates for the high-risk infant, yet developmental delays are common due to complications resulting from immature organ systems. The neonatal intensive care unit environment itself may pose barriers to optimal development of these infants. The purpose of this study was to investigate the effects of an oval-shaped cloth nest to make the environment less stressful and enhance neonatal development. Specifically, the study hypothesized that infants who were placed in the cloth nest would gain more weight and would have shorter lengths of hospital stay than would infants receiving routine care. A total of 102 healthy infants ranging from 26 to 31 weeks of gestation were recruited into the study. No significant differences were found in the groups on amount of weight gained. Infants who were placed in the cloth nest actually had longer hospital stays than did infants receiving routine care. Perhaps infants who received routine care received more touch than did nested infants, and the touch may have facilitated development as measured by length of stay.

Bedding and Linens↗

PubMed1997

Interpreting fetal heart rate tracings. Is there a difference between labor and delivery nurses and obstetricians?

OBJECTIVE: To analyze the influence of increasing education and clinical experience on fetal heart rate interpretation by health care providers in labor and delivery areas. STUDY DESIGN: Eleven tracings representing a variety of fetal heart rate patterns and neonatal outcomes were selected. Respondents were asked to interpret the tracing strips on a 1-5 scale and predict Apgar scores and cord blood gases. RESULTS: Seventy nurses and physicians participated. Experience with labor and delivery and provider classification correlated significantly with correct interpretation. Certified nurse midwives differed significantly in number of correct interpretations from both first-year residents and low-risk nurses. Providers did not differ on ability to predict Apgar scores or cord gases. CONCLUSION: Length of clinical experience correlated positively with the interpretation of fetal heart rate tracings but not with the prediction of Apgar scores or cord blood gas measurements. These data will be useful in designing educational and orientation programs for physicians and nurses in the labor and delivery setting.

Apgar Score↗

PubMed1996

Accuracy of maternal perception of preterm uterine activity.

OBJECTIVE: Our purpose was to compare the accuracy of maternal perception of preterm uterine activity by self-palpation versus home uterine activity monitoring. STUDY DESIGN: A total of 72,962 uterine activity records of 778 women receiving home uterine activity monitoring services were analyzed. Simultaneously with home uterine activity monitoring, the women indicated by an electronic marker when they felt a "contraction" through self-palpation. The perceptions of the women were compared to the tocodynamometrically measured uterine activity. RESULTS: Using self-palpation, women correctly identified 17.2% of contractions recorded by tocodynamometry. Overall mean percent correct correlation per patient was only 14.1%. Patients missed an average of 85.7% of their contractions. Patients incorrectly perceived contractions that were not present an average of 40.3% of the time. Singleton gestations had significantly better correct correlations than twin gestations. Multiparous women had improved correlations compared with primiparous women. No significant correlation was found between maternal perceptive ability and gestational age. CONCLUSION: Women were unable to perceive accurately the presence or absence of preterm uterine activity through self-palpation compared with simultaneous measurement by home uterine tocodynamometry.

Adult↗

PubMed1996

Perinatal and health care management consequences of twice-a-day versus once-a-day evaluation of home uterine activity monitoring data.

There was a significant increase in the number of physician interventions (additional testing of mother or baby; extra office, emergency, or labor and delivery unit visits; and especially extra hospitalizations) but no significant difference in perinatal outcome (illness in mother or baby) when women at high-risk for preterm labor on home uterine activity monitoring services had scheduled twice-a-day review (BID review) of the home uterine activity monitoring data they had collected versus once-a-day review (OD review).

Adult↗

PubMed1995

Computer-assisted video evaluation of surgical skills.

Compact video cameras have allowed the review of operations in self-directed learning sessions. Controlling the video viewing process by computer allows the selection of specific videotape segments containing the desired psychomotor skills to be evaluated--in this study, the steps involving laparoscopic tubal banding. Six faculty members were able to evaluate 23 videotapes efficiently without knowledge of the resident operator's identity. Because the computer allowed selection of only those frames of the videotape containing the skills to be evaluated, the duration of videotape seen was reduced by an average of 34% from the actual surgical time, with an increase in time saved as experience with the system was gained. Faculty members evaluated these events using a self-made checklist. It was possible to calculate the performance scores of each resident for the individual psychomotor skill components of the reviewed procedure. Computer-assisted video evaluation of surgical skills is technically feasible, allowing time-efficient review by multiple evaluators. With the development of psychometrically valid checklists for use with this technology, computer-assisted video evaluation of surgical skills may provide a new, innovative means of assessing surgical skills and training.

Clinical Competence↗

PubMed1991

Auscultation with an esophageal stethoscope. A new test for pneumoperitoneum.

Auscultation for the tympanic sound characteristic of developing pneumoperitoneum during insufflation of the abdomen at laparoscopy was performed with an esophageal stethoscope. Such auscultation detected pneumoperitoneum as soon as or sooner than did the other, standard methods to which it was compared. This test requires no additional maneuvers beyond those routine in standard laparoscopic and anesthetic procedures, providing a useful adjunctive test for pneumoperitoneum acquisition.

Adult↗

PubMed1990

Effect of a structured antepartum exercise program on pregnancy and labor outcome in primiparas.

The labor and delivery outcomes were compared for 50 low-risk primiparas who voluntarily participated in a structured, nonendurance antepartum exercise program and a similar, nonexercising control group. No adverse effects on fetal well-being were noted in the exercising group. However, those who exercised had significantly shorter first and second stages of labor (mean length, 7.55 and 1.33 hours, respectively; P less than .001) as compared to those who did not exercise (mean length, 14.46 and 2.47 hours, respectively; P less than .001). The exercising primiparas were also less likely to require oxytocin augmentation of labor and more likely to have spontaneous vaginal deliveries. The data suggest that there might be beneficial effects from nonendurance antepartum exercise regimens for women with normal pregnancies. Hence, the data have implications for the counsel given pregnant women about antenatal exercise and for future research on exercise during pregnancy.

Adult↗

PubMed1989

Gynecologic health care of women with disabilities.

Information about their gynecologic health care was obtained from 55 women with acquired and congenital disabilities, 42% of whom were disabled after menarche. Although 91% of the entire group had received breast and pelvic examinations and Papanicolaou smears since their disability, only 18.8% had received counseling about sexuality and 64.6% had received information about contraception. However, those disabled after menarche were significantly less likely (P = .001) to be satisfied with the counseling or method they received. Women with paralysis, impaired motor function, obvious physical deformity were rarely offered contraceptive information or methods. These findings may be related in part to the characteristics of the patient group. However, we suggest that special attention needs to be directed to those disabled after menarche with respect to issues such as sexuality and contraception. This can be accomplished in part through improved education of health professionals regarding the various aspects of gynecologic health care for the disabled.

Activities of Daily Living↗

PubMedDate not supplied

Perceived barriers to prenatal care services.

PURPOSE: The purpose of this study was to determine barriers to prenatal care services and to determine if barriers differed by demographic characteristics in a low-income population. DESIGN: Descriptive correlational study with 110 women who sought prenatal care after the 20th week of gestation. RESULTS: Two items were major barriers to seeking prenatal care: long waiting times at the time of appointments and the cost of getting care. Significant relationships were found based on the age and race of the women. CLINICAL IMPLICATIONS: Some identifiable variables prevented these women from seeking early prenatal care; however, the barriers identified are amenable to change. Strategies to reduce barriers could include providing more culturally competent care, more timely appointments, better use of the woman's time when appointments are kept, educating women in the community about the availability of low-cost care, and assistance at prenatal care sites for facilitating completion of insurance and financial applications. Barriers to prenatal care varied by demographic group; therefore, identifying the characteristics of the group being served seems important in efforts to decrease barriers to care.

Adolescent↗

PubMedDate not supplied

Maternal-child health in Brazil.

An overview of the social and economic climates and the healthcare delivery systems of Brazil is presented. The Brazilian healthcare system is discussed, with particular attention directed to the status of nursing and to the perinatal health-care delivery system. Examples of Brazilian perinatal health-care practices are provided.

Brazil↗

PubMedDate not supplied

Teaching nursing students to critically evaluate electronic fetal monitor tracings.

Evaluation of electronic fetal monitor (EFM) tracings is challenging for nursing students and novice perinatal nurses. Use of a standardized nursing process tool facilitates recognition of electronic fetal monitoring patterns and application of appropriate nursing interventions. Feedback from expert nurses and nursing instructors validates students' critical thinking skills.

Analysis of Variance↗

PubMedDate not supplied

Postterm pregnancy: effects on temperature and glucose regulation.

Pregnancies that extend beyond 42 weeks of gestation have a higher risk for uteroplacental insufficiency than do pregnancies delivered prior to this time. Postterm infants are at risk for meconium aspiration due to uteroplacental insufficiency. Prior research has shown that postterm infants are at risk for temperature- and glucose-regulating difficulties following birth. In this study, the abilities of 63 postterm infants and 88 term infants to regulate temperature and glucose during the first 24 hours of infant age were compared. No significant differences were found in the two groups on the two variables.

Adult↗