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Biomedical subjects

J Reigle

Publications and source records attributed to J Reigle.

10 recordsLinked to original sources
PubMed2000

Sudden cardiac death in heart failure.

Chronic heart failure (HF) and sudden cardiac death (SCD) present two major public health problems. The risk of death ranges from 10% to 50% annually in patients with HF, depending on the severity of disease. Approximately 50% of these deaths are sudden and presumed to be caused by dysrhythmias. This article defines the population at risk for SCD, explains the methods used for risk stratification, reviews current research on the pathophysiology of ventricular dysrhythmias in HF, and discusses pertinent clinical trials of therapeutic interventions on SCD in HF. The article also explores the effect of SCD on the patient and family with respect to counseling and education, resuscitative issues, and advanced directives.

Arrhythmias, Cardiac↗
PubMed1999

Card sort: an assessment tool for the educational needs of patients with heart failure.

BACKGROUND: Effective education of patients is an integral component in reducing hospital readmissions for patients with heart failure and in improving patients' quality of life. OBJECTIVES: To describe the use of a card sort method for determining the learning needs of patients with heart failure and the ability of nurses and physicians to accurately predict patients' self-determined needs. METHODS: Thirty patients were asked to sort 12 cards with questions related to the content of discharge teaching for patients with heart failure. The nurse and the physician caring for each patient were instructed to sort the cards independently to characterize the learning needs of the patient. RESULTS: Patients most often selected the following as the most important educational topics: What is wrong with my heart? What is the future of my disease? and How will I know if my heart failure is getting worse? Physicians selected the identical top question as their patients did 17% of the time. Physicians matched any of their patients' top 3 choices 34% of the time. Questions selected as most important by patients were chosen by physicians as least important 13% of the time. Nurses chose the same top question as their patients did 23% of the time. Nurses matched any of their patients' top 3 choices 34% of the time. Nurses selected opposite choices from those of their patients 6% of the time. CONCLUSIONS: The card sort method may be an effective tool to ascertain the individual learning needs of patients with heart failure.

Adult↗
PubMed1998

Mechanisms and management of ventricular dysrhythmias in heart failure.

Despite recent pharmacologic and surgical advances in the management of heart failure, the morbidity and mortality rates of this chronic illness remain high. Ventricular dysrhythmias are common in heart failure and may be independently associated with increased mortality rates. Although the risks of sudden cardiac death leading to the patient's death are increased by the presence of complex ventricular dysrhythmias, the management of dysrhythmias is subject to controversy. The purpose of this article is to review the normal electrophysiologic properties of the heart and to examine the likely mechanisms, diagnostic approaches, and proposed treatments for ventricular dysrhythmias in heart failure.

Anti-Arrhythmia Agents↗
PubMed1996

The ethics of physical restraints in critical care.

The use of restraints in the critical care setting represents an extreme end on the continuum of behavioral management. Restraints increase a person's vulnerability to neglect, harm, and exploitation and are associated with significant physical harm and devastating psychologic consequences. The central values of respect for persons, preventing harm, and promoting positive outcomes often conflict when physical restraints are used. This article explores the ethical issues confronting critical care nurses as they weigh the potential harms associated with restraints against the primary commitment to the patient's health and safety. The challenge for critical care nurses is to establish more humane and dignified forms of care for critically ill patients.

Critical Care↗
PubMed1990

Limiting care: should age be a criterion?

The rising costs of health care coupled with the dramatic increase in the number of individuals over the age of 65 years presents the health care industry with the dilemma of an increased demand for services and goods, with limited resources. Physicians, economists, and ethicists have suggested various solutions to this problem, including the controversial proposal strongly advocated by Daniel Callahan, of age-based rationing. This article explores some of the issues that are woven into the allocation of health care resources based on age. Although there are no easy answers to this dilemma, the critical care nurse needs to be familiar with these issues to function effectively as a patient advocate. Some suggestions to enhance this aspect of critical care nursing will also be discussed.

Age Factors↗
PubMed1989

Resource allocation decisions in critical care nursing.

One of the major challenges for critical care nurses is to distribute their professional services in a manner that is consistent with the moral imperatives of nursing. The central values of respect for individual patients, patient-centered beneficence, full beneficence, and justice must be woven together into an ethical framework that assists nurses in allocating their skills. Professional organizations, such as the AACN, are actively trying to order this ethical disorder by proposing guidelines that, on the one hand, acknowledge societal interests in cost-effective utilization of health care resources, and on the other hand, safeguard the interests and well-being of individual patients. In addition to the guidance from professional organizations, health care institutions should address the inequities in health care by developing policies that guide the health care team through an ethical decision-making process. Nurses, as members of the multidisciplinary health care team and as members of an essential and scarce resource, should participate in formulating these directives. Not only is bedside and institutional involvement important, but participation at the local, state, and national levels will empower nurses to influence decisions of resource allocation at the micro and macro levels.

Beneficence↗