Biomedical subjects

K J Ribby

Publications and source records attributed to K J Ribby.

4 recordsLinked to original sources

PubMed1998

Temporary stoppage of peritoneal dialysis when laparoscopic procedures are performed on patients undergoing CAPD/CCPD: a change in policy.

Laparoscopic surgery has been gaining in popularity. Prior to 1995, whenever our patients had a laparoscopic procedure it was carried out with the standard precautions, and the patient stayed on peritoneal dialysis (PD). We noticed a high incidence (71.4%) of peritonitis post laparoscopic surgery. Four of the peritonitis patients had cholecystectomies and 1 had a gastrostomy for placement of a feeding tube laparoscopically. The patients' ages ranged from 31 to 74 years; 4 (80%) were females. They had been on PD for a mean of 24 months (range 6-48 months). Peritonitis was diagnosed within a mean of 22.2 hours (r: 12-36 h) post procedure. The causative organisms were Klebsiella in two cases, Staph. aureus in one, Pseudomonas in one, with no growth observed in one. Following this, we instituted a deliberate policy of temporary cessation of PD for 2 weeks post laparoscopic procedure, maintaining the patient on hemodialysis during this period. Since the adoption of this policy, we have had no peritonitis in 7 patients who have undergone laparoscopic procedures.

Adult↗

PubMed1997

Dust off the policy and procedure manual to develop an orientation program.

With clear and accurate peritoneal dialysis departmental policies, procedures, and patient care standards, the creation of an orientation module with objective and measurable patient care and staff performance outcomes is easily produced. This article describes revision of policies, procedures, and patient care standards, and an approach for building linkages with the employee orientation program. No formal classroom time is required, and the level of orientee experience is accommodated. All peritoneal dialysis staff members are capable of equal preceptor participation.

Education, Nursing, Continuing↗

PubMed1996

Development, implementation, and evaluation of a confusion protocol.

Because the phenomena of managing and therapeutically responding to confused elderly hospitalized patients is complex and difficult, a group of advanced practice nurses, supported by a pharmacist, nursing administration, and a School of Nursing professor, was commissioned to explore the research-based literature and provide practice recommendations for these patients. This article identifies one process undertaken for synthesizing and grounding an immense body of literature related to confused elderly patients. The literature review served to begin clarifying the differences between the diagnosis and required interventions for managing either acute or chronic confusion. These interventions were articulated within a protocol format (Marker model) familiar to staff members at our institution. The development, implementation, and evaluation of the protocol is presented, as well as suggestions for further research.

Acute Disease↗

PubMedDate not supplied

Organization and development of a pediatric end stage renal disease teaching protocol for peritoneal dialysis.

Peritoneal dialysis is one of the treatments for end stage renal disease that requires considerable expertise. When neonates or children develop end stage renal disease, both the patient and family members must be provided with substantial education and training. The organization of education and training is paramount, especially as length of stay is limited with managed care. The development of an organized interdisciplinary approach for this instruction and pediatric patient teaching protocol for management of home peritoneal dialysis therapy is discussed in this article. The protocol provides learning content, methodologies and patient/family outcomes and is accompanied by a documentation tool that serves as communication for directing team member reinforcement of content until outcomes are met. Since completion of the protocol, eight pediatric patients have been placed on this teaching plan with extremely positive outcomes.

Adolescent↗