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Biomedical subjects

D A Krenzischek

Publications and source records attributed to D A Krenzischek.

6 recordsLinked to original sources
PubMed2001

Evaluation of ASPAN's preoperative patient teaching videos on general, regional, and minimum alveolar concentration/conscious sedation anesthesia.

This descriptive study was undertaken as part of a clinical improvement effort by the ASPAN Research and Education Committees to evaluate adult patients' perception of and satisfaction with the ASPAN Preoperative Patient Teaching videotape on general, regional, and minimum alveolar concentration (MAC)/conscious sedation anesthesia. Research findings on the use of videotapes for preoperative education are mixed. Some studies have reported that the use of videotapes increases knowledge and decreases anxiety, whereas other studies have shown a minimal effect on knowledge and anxiety. A convenience sample of 96 adult patients was chosen from those who were scheduled for surgeries with the above anesthesia techniques in 11 US hospitals and/or surgical centers within 4 ASPAN regional boundaries. Patients viewed the videotape the day(s) before surgery and then completed ASPAN's Preoperative Anesthesia Patient Teaching Questionnaire to measure patient perception and satisfaction. Sixty percent of the patients were women, and 50% had a college degree or higher. The average age of the patients was 51 (+/-17.2). Overall satisfaction scores had a potential range of 10 to 40, with higher scores indicating greater satisfaction. The mean satisfaction score for this study was 35 (+/-6.6). No significant relationships were found between satisfaction with the videotape and age, gender, or educational level. Patients were asked to rank each of 4 teaching methods. Among the choices of individualized instruction, written materials, Internet-based instruction, and videotape, the videotape method was ranked as most preferred. The information obtained from this study will be used to modify and improve the content of the patient education videotape produced by ASPAN.

Adult↗
PubMed1996

Comparative study of bedside and laboratory measurements of hemoglobin.

OBJECTIVE: The purpose of this study was to examine the effects of variations in technique on measurements of hemoglobin level done at the bedside and to compare these results with laboratory measurements of hemoglobin. DESIGN: In accordance with hospital policy, procedure, and protocol, various techniques were used to obtain samples of capillary and venous blood and of blood from arterial and central venous catheters. Levels of hemoglobin were measured at the bedside and in the laboratory, and the results were compared. SETTING: The Johns Hopkins Hospital adult postanesthesia care unit. SAMPLE: A total of 187 blood samples were obtained from 62 adults who had undergone general surgery. Group I comprised 20 subjects with capillary and venous blood samples. Group II comprised 21 subjects with arterial blood samples. Group III comprised 21 subjects with central venous blood samples. RESULTS: The results showed that the amount of blood to be discarded before obtaining samples of arterial and central venous blood need not be any larger than double the dead space of the catheter, and that shaking the blood sample for 10 seconds was sufficient to mix the sample before measurement of hemoglobin levels. Results of bedside and laboratory measurements of hemoglobin level were comparable. CONCLUSION: Bedside measurement of hemoglobin increases efficiency in patient care, decreases risk of blood-transmitted infection for staff, and decreases cost to the patient. However, the persons who perform the assay must be responsible in adhering to the standard of practice to minimize errors in the measurements.

Adult↗
PubMed1995

Forced-air warming versus routine thermal care and core temperature measurement sites.

Hypothermia occurs commonly during the perioperative period and is preventable with proper warming measures and body temperature monitoring. Using a prospective, randomized study design, we compared forced-air warming (Warm Touch, Mallinckrodt Medical, Inc, St Louis, MO) (n = 15) with routine thermal care (n = 14) during the intraoperative and early postoperative periods. The results show that compared with routine thermal care, forced-air warming resulted in higher core temperatures both intraoperatively and postoperatively. The incidence of shivering was lower and thermal comfort scores were higher in the warming group. A secondary focus in this study was to assess the correlation between body temperatures measured at the urinary bladder, oral cavity, rectum, and tympanic membrane. The results indicated that the sites most highly correlated with tympanic temperature (listed in order of most to least correlated) were the bladder, rectum, and oral cavity. Assuming tympanic temperature is most representative of "core" temperature, oral measurements were likely to underestimate core temperature, whereas bladder and rectal temperatures overestimated core temperature. The relationship between body temperatures measured at commonly used monitoring sites must be recognized by nurses to account for the tendency to overestimate or underestimate core temperature. This knowledge can be applied in the management of patients in the operating room or PACU and specifically in the evaluation of PACU patients before discharge.

Aged↗
PubMed1992

A pilot study to assess the relationship between behavioral manifestations and self-report of pain in postanesthesia care unit patients.

The Chambers and Price Pain Rating Scale was adapted to measure the relationship between behavioral manifestations and self-report of pain in PACU patients. This article discusses the result of a pilot study of the adapted tool. The internal consistency of the tool using coefficient alpha was 0.92. Interrater reliability for each category of the scale, using Pearson's correlation, ranged from 0.71 to 1.0. Thirty subjects were observed by the investigators at two times. In the first observation, frowning or grimacing was the only behavior significantly related to self-reported pain. In the second observation, muscle tension and patient sounds were significantly related to self-report of pain. The results suggest a sequence of pain behaviors in patients recovering from anesthesia. Thus, careful attention to certain behaviors in the recovery period, with a broader focus of assessment in the recovery period, may be necessary for accurate pain assessment.

Adult↗