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Biomedical subjects

L Foster

Publications and source records attributed to L Foster.

64 records · Page 4Linked to original sources
PubMedDate not supplied

Technology assessment--a survey of the clinical engineer's role within the hospital.

Advancements in technology are vital to improve clinical outcomes within the medical community and, in particular, to healthcare systems. The need for a systematic approach to analyzing, assessing and selecting the best new technology for individual hospitals continues to increase in response to this technological growth. To determine the use of technology assessment, the effectiveness of different methods, and the role of clinical engineers and bioengineers in this process, a survey was conducted of clinical engineering departments throughout the United States. The results reveal that technology assessment programs are widely utilized as a team effort between hospital departments. Clinical engineers are playing a key role within these teams as technology managers.

Attitude of Health Personnel↗
PubMedDate not supplied

Acute surgical wound care 1: An overview of treatment.

The first article in this series of articles on acute surgical wound care traces the history of surgical wound care, from primitive dressings and techniques of closure used in the past to the present-day approach. The history of surgical wounds is discussed together with a classification of the different types of surgical wound closure. Nowadays, it is recognized that the management of surgical wounds has to be planned carefully to achieve adequate exposure to the area of surgery. At the same time the surgeon has to be conscious of how the wound will heal to ensure optimal postoperative function and cosmetic results. To do this an understanding of the principles underpinning surgical incisions, and of alternative techniques for their closure, drainage and wound dressing, is needed. The role of the nurse in preparing patients preoperatively and supporting and caring for them postoperatively is paramount.

Bandages↗
PubMedDate not supplied

Acute surgical wound care. 2: The wound healing process.

The first article in this series on acute surgical wound care traced the history of surgical wound care from primitive dressings and techniques of closure used in the past to the present-day approaches. It also outlined the classification of acute surgical wounds (Vol 7(18): 1101-6). This second article describes the four stages of wound healing in acute surgical wounds, using clinical slides to illustrate the wound healing process. General factors, such as age, nutrition and medication, and local factors, including a moist environment, blood supply and wound infection, will be discussed to demonstrate their importance in promoting optimum wound healing.

Humans↗
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Acute surgical wound care. 3: Fitting the dressing to the wound.

The third article in this series on surgical wound care discusses the types of dressings currently available, and selection of the correct dressing for a particular wound type. There is an abundance of information on the types of dressings available. Wound management for the individual patient must be decided using best evidence and taking into account patients' increased involvement in their care, new technology and the push to mobilize early, leading to early discharge from hospital. The nurse needs to have a good knowledge of the types of dressings available, the properties of individual dressings and a sound understanding of wound healing, in order to make an informed decision on wound management. General factors such as safety, comfort, pain management and convenience must be borne in mind when deciding which dressing is the best for individual patients, given that dressings now have to be cost-effective as well as clinically effective.

Bandages↗
PubMedDate not supplied

Acute surgical wound care. 4: The importance of documentation.

This article, the last in a series of four, discusses the importance of documenting wound care. Studies have shown that nurses do not document wound care as often, or as accurately, as they should in order to comply with the UKCC's (1998) Guidelines for Records and Record Keeping. Although some wound assessment charts have been published and are in use, there is still concern about the validity or reliability of some of these charts. Studies show that further research is necessary in order to validate the charts that are currently in use. An increase in litigation has placed more emphasis on accurate record keeping which shows, in detail, the wound care that is given to each patient. Patients also want to be more informed about their treatment, and this can be done through the use of clinical pathways or multidisciplinary documents. This article also discusses the factors that have to be considered when putting a wound care chart together and gives some examples of existing charts.

Acute Disease↗
PubMedDate not supplied

Cost benefits of two dressings in the management of surgical wounds.

In this prospective randomized controlled trial of the cost benefits of the choice of dressings in acute surgical wounds left to heal by secondary intention, patients had their wounds dressed with either a traditional dressing (ribbon gauze soaked in proflavine) or a modern hydrofibre dressing. Results showed that the hydrofibre dressing, although more expensive than the ribbon gauze, facilitated an earlier discharge from hospital (P = 0.001). The total cost of the patient episode was less in the hydrofibre group (P = 0.01). In an average UK health authority of 300,000 population, 100 bed days a year could be saved releasing an overall potential saving of 55,000 Pounds. A modern hydrofibre dressing allows more effective use of scarce hospital beds and precious financial resources, while still maintaining high quality patient care. It is important that clinical specialists and purchasers of health care should be aware of this clinical and cost-effective advance in the management of acute surgical wounds.

Abscess↗
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The use of a hydrofibre dressing in fulminating necrotizing fasciitis.

This article describes a case of necrotizing fasciitis in a 52-year-old man with previously undiagnosed diabetes. Treatment involved massive debridement and subsequent dressing of the open surgical wound. A modern hydrofibre dressing (Aquacel) was inserted intraoperatively and subsequently continued postoperatively. Wound healing occurred over 3 months and the patient was discharged with no disability. The dressing managed the exudate level and kept the wound moist. It also was well tolerated by the patient, was comfortable and easy for the nurses to remove and apply.

Carboxymethylcellulose Sodium↗
PubMedDate not supplied

Implementing a year-long, worksite-based incentive program for smoking cessation.

BACKGROUND: There have been few reports of the process of implementing ongoing worksite health promotion programs. This article describes the implementation of a year-long smoking cessation program in nine worksites employing a total of approximately 700 smokers. METHODS: Issues discussed include: forming a partnership with organizations, design of the multicomponent incentive intervention, program promotion, maintaining participation, and the need to modify program components over time. RESULTS: The program produced high participation rates (29% of smokers joined the program) and moderate cessation rates among participants (during the last half of the program, monthly cessation rates averaged 20%). There was marked variability across worksites on both participation and cessation, and qualitative features of organizations associated with outcome are discussed. DISCUSSION: The importance of working with employee steering committees to tailor health promotion programs to fit the organization is discussed. The article concludes with recommendations for implementation of similar programs.

Follow-Up Studies↗