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Biomedical subjects

K K Misra

Publications and source records attributed to K K Misra.

4 recordsLinked to original sources

Nursing the immobile: a preliminary study.

Permanent loss of mobility has profound physical and mental consequences for both sufferers and carers, and is a major challenge to the National Health Service. A recent study has shown that 42% of beds in departments of Geriatric Medicine are occupied by people with longstanding immobility. These people are highly dependent on nursing staff for their daily activities and quality of life. The assessment of mobility, as a single parameter of dependency, and the measurement of allocated nursing hours are both rapidly and easily performed on geriatric wards. It is felt that a simple correlation of these two variables might highlight areas where more detailed audit is desirable. This study demonstrates that the more immobile patients on a ward, the less the hours allocated to Registered and Learner grade nurses. Some possible reasons for this are suggested and the effects of this deployment on nursing practice and staff recruitment are discussed. It is felt that provision of appropriate nursing care to the most dependent patients in continuing care areas is essential, and that high levels of trained staff are needed to ensure this.

Activities of Daily Living

The bedfast.

Many geriatric beds are occupied by bedfast patients. Most were immobile from the time of admission and many were admitted from other hospital departments or residential care. More are discharged home than remain in hospital or are transferred to any other institution. Although a small minority of admissions become long-term bedfast inpatients this group require a disproportionate resource commitment. Reduction in the number of bedfast inpatients is more likely to be effected by changes in unit policy than by improvement in clinical practice.

Aged

Determinants of work capability and employment after coronary artery surgery.

In 120 patients subjected to coronary artery surgery we have investigated employment status and work capability in relation to age, pre-operative ventricular function and extent of coronary artery disease, peri-operative infarction and post-operative angina. The patients were followed up for 6 to 23 months (mean 10 months). Fifty-three out of 74 patients (72%) employed before the onset of angina, returned to work after operation. Return to work was more likely in patients working immediately prior to surgery and in patients less than 45 years old (P less than 0.05). Sixty patients (50%) reported a return to normal work capability, the most striking changes occurring in those less than 45 years old (P less than 0.02). Pre-operative left ventricular (LV) function and extent of coronary disease and mode of employment did not correlate with post-operative employment status but normal LV function was related to improvement in work capability (P less than 0.02). Return to work after coronary bypass surgery is mainly due to angina relief but is also related to age and pre-operative work status.

Adult