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Biomedical subjects

E Larson

Publications and source records attributed to E Larson.

At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

Hospitalk: an exploratory study to assess what is said and what is heard between physicians and nurses.

OBJECTIVE: Collaboration and effective communication between healthcare professionals has been demonstrated to improve patient outcomes and job satisfaction. The purpose of this study was to examine physician and nurse communication in a hospital setting during a time of very rapid change. DATA SOURCES AND STUDY SETTING: Full-time attending internal medicine physicians (n = 5), registered nurses (n = 18), and medical residents (n = 12) working on two adult medical units in a 325-bed tertiary-care hospital in the mid-Atlantic region from fall 1996 to summer 1997. STUDY DESIGN: Descriptive survey and interview. DATA COLLECTION METHODS: Each subject completed a written questionnaire, Physician-Nurse Communication Scale, and a structured interview with a trained social linguistics team. PRINCIPAL FINDINGS: Physicians and nurses shared similar perceptions regarding their roles in communication processes, such as giving orders, asking for information, and asking for and giving opinions. They differed significantly in the perceptions of the physician and nurse roles in giving information, orienting, and providing education. Generally, physicians perceived that nurses initiated certain types of communication significantly less often than did nurses. Both groups expressed an interest in more interaction; nurses particularly expressed the need to be "listened to" or respected more. Nurses were significantly more likely to express the need to change interactions with house staff than with attending physicians (P = .02). CONCLUSIONS: Interactions between physicians and nurses are perceived differently by the two groups, leading to misunderstanding of motive and meaning. Recommendations are made to improve communication between these two professional groups.

Adult↗
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Assessment of alternative hand hygiene regimens to improve skin health among neonatal intensive care unit nurses.

OBJECTIVE: The frequent handwashing and gloving required in high-risk, high-volume patient care areas such as critical care units damages skin of the hands. The purpose of this exploratory study was to compare 2 hand care regimens (traditional antiseptic wash with chlorhexidine-containing detergent versus mild soap wash with subsequent alcohol-based rinse for degerming as necessary) in a neonatal intensive care unit (NICU). DESIGN: Prospective, quasi-experimental, random assignment. SETTING: One NICU (47 beds) in a New York City children's hospital. SUBJECTS: Sixteen full-time NICU nurses. OUTCOME MEASURES: Microbial flora and skin condition of hands. INTERVENTION: Nurses were randomly assigned to one of the 2 hand care regimens. RESULTS: No significant differences in microbial counts or types of organisms from hands of staff were found, but after 2 weeks nurses in the mild soap and alcohol group had significant improvements in their skin condition (P =.005). CONCLUSIONS: Use of a mild soap for cleaning and an alcohol-based product for degerming may offer an acceptable alternative to the traditional antiseptic handwash and may reduce skin damage to health care professionals' hands.

2-Propanol↗
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Factors associated with regular aerobic exercise in an elderly population.

BACKGROUND: Little is known regarding the characteristics of elderly persons who do not regularly exercise. This lack of knowledge limits the design and marketing of exercise programs to persons who could benefit from regular exercise. METHODS: We compared characteristics of regular exercisers and nonexercisers among 561 randomly selected persons aged 65 years and older who were enrollees of a health maintenance organization. Baseline data were obtained on sociodemographics, health attitudes, and medical conditions. RESULTS: Of the 561 persons studied, 192 (34 percent) were regular exercisers. Exercisers were slightly younger than nonexercisers and reported more positive health perceptions. Nonexercisers tended to report lower incomes and lower educational levels than did exercisers. Exercisers were less likely to report hypertension, arthritis, or two or more of the following medical conditions: heart disease, hypertension, arthritis, and emphysema (odds ratio 0.49; confidence interval 0.28 to 0.86). Sex differences were present. In logistic regression analysis, higher reported income, better perception of current health, and fewer than two medical conditions were associated with regular exercise status. CONCLUSIONS: Specific characteristics are present in persons who regularly exercise compared with those who do not. These findings may prove useful in understanding the dynamics of exercise behavior in this age group and in designing exercise interventions for this population.

Age Factors↗
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A comparison of transparent adherent and dry sterile gauze dressings for long-term central catheters in patients undergoing bone marrow transplant.

Patients undergoing bone marrow transplant (BMT) are at great risk of infection and sepsis. Long-term central catheters (LTCCs), required for IV therapy, can be a portal of entry for infectious agents. This randomized, prospective study compared two types of catheter dressings in 98 patients undergoing BMT: a dry sterile gauze dressing (DSGD) changed daily and a transparent adherent dressing (TAD) changed every four days. Study outcomes included incidence and severity of local and systemic complications, patient assessment of comfort, and calculation of nursing time. One case of catheter-related infection occurred during the study. No significant differences existed between the two dressings in the incidence of positive skin cultures or local complications with the exception of skin irritation. The TAD caused less skin irritation, was preferred by patients, cost less, and required less nursing time. The findings indicate that TADs provide a safe, comfortable, and cost-effective alternative to DSGDs for patients undergoing BMT and receiving antibiotic support during aplasia.

Adolescent↗
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Patient experiences with research in a tertiary care setting.

Data from a number of studies indicate that patients' understanding and recall of information presented during the informed consent process are poor. The purpose of this survey was to determine patients' attitudes about, desired knowledge of, and involvement in clinical research in a tertiary medical care setting. A self-report questionnaire was completed by 277 patients on the oncology, obstetrics/gynecology, medicine, neurosciences, surgery, and ophthalmology services of a large tertiary care facility. While most respondents had generally positive attitudes about research, relatively few were aware that human subjects approval processes existed or that nurses conducted research. Areas of additional knowledge needed included specific information about purposes of research and risks and benefits. Individuals with higher levels of education appeared more willing to participate in clinical research even when personal benefit was minimal.

Adolescent↗
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Integrity of vinyl and latex procedure gloves.

In a series of experiments the integrity of vinyl and latex procedure gloves were tested under in-use conditions. Both types of gloves were tested by three methods: watertight (645 samples), bacterial penetration (50), and dye exclusion (90). Results of the watertight test demonstrated visible defects in 4.1% of vinyl and 2.7% in latex gloves. Twenty percent of latex gloves and 34% of vinyl gloves which had passed the watertight test allowed penetration of Serratia marcescens when worn by volunteers. A series of manipulations designed to simulate approximately 15 minutes of clinical activity in an intensive care unit resulted in failure rates as high as 66%. Using the dye penetration test, there was a statistically significant difference between vinyl and latex procedure gloves with full manipulations, with failure rates of 53% and 3%, respectively. Both types of gloves provided some barrier protection. However, latex gloves performed better when stressed.

Adult↗
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Nursing care of the patient receiving subcutaneous low-dose Ara-C therapy.

Although a number of reports have suggested clinical efficacy of low-dose Ara-C (LoDAC) in the treatment of acute non-lymphocytic leukemia (ANLL) and myelodysplastic syndromes (MDS), this therapy remains controversial. Clinical trials presently are being conducted to determine the efficacy of LoDAC in these hematologic disorders. Patient education related to self-administration of the agent and monitoring of potential toxicities are primary components of nursing management. It is likely that nurses in acute care, ambulatory, and community settings will be involved in the management of patients receiving this therapy.

Bone Marrow↗
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Nursing research and AIDS.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
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Rational product evaluation.

This article describes a systematic method for planning and implementing a program for product evaluation. Steps for the planning process include appointing a centralized, decision-making group, developing an evaluation plan, implementing mechanisms to introduce new products, defining follow-up methods, and developing methods to identify product needs. Steps in the implementation process include initiating product requests, exploring options, evaluating options, and summarizing findings on which to base a final product decision. A tool for product evaluation is presented.

Communication↗