Biomedical subjects
Linda Harrington
Publications and source records attributed to Linda Harrington.
Staying alert about NAPS.
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Ask the experts. Basing vasoactive drips on body weight for bariatric patients.
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Proactive care management focuses on quality and communication.
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Administer single-site 30-mL intramuscular injection?
A physician orders fosphenytoin to be administered intramuscularly in a dosage of 30 mL in volume. A change in the traditional practice of limiting intramuscular injection volumes to 5 mL in adult patients is discussed.
Food and drug interactions in critically ill adults.
What happens when two needed therapies collide in the critically ill patient? This article explores the negative interaction of food and drugs that can occur along with important nursing implications. Also included is a discussion on the development of a food-drug interaction program, a multifaceted and comprehensive approach to monitoring, evaluating, reporting, and reducing the occurrence of food-drug interactions.
Nutrition in critically ill adults: key processes and outcomes.
Malnutrition is a common problem that can have serious consequences for the already compromised critically ill adult. Nurses are often challenged to quantify the risk or degree of malnutrition, identify the amount or type of support needed, or measure the effectiveness of nutritional intervention. This article focuses on key processes used to provide nutrition therapy to critically ill adults. These processes and how nurses employ them have the greatest potential impact on outcomes related to nutrition in critically ill adults.
Nurse-administered propofol sedation: a review of current evidence.
This article highlights a highly controversial practice issue referred to as nurse-administered propofol sedation, which affects registered nurses as well as advanced practice nurses in many different practice settings across the United States. Amid varied advice from professional organizations and state licensing boards, a thorough and systematic review of the current evidence provides insight into the question of safety associated with the practice. The evidence examined includes position statements from professional organizations and state boards, information from the United States Food and Drug Administration and the Joint Commission on Accreditation of Healthcare Organizations, and published research since 1999. The body of evidence demonstrates diverse positions; however, the empirical evidence in the author's opinion unanimously supports nurse-administered propofol sedation as a safe practice in nonintubated adult patients. Under research conditions, participants had a low incidence of untoward events and were adequately rescued with no intubations required and no deaths reported.
Potassium protocols: in search of evidence.
PURPOSE: The purpose of this triangulated study was to evaluate potassium protocols used in clinical practice. RATIONALE: Hypokalemia occurs frequently in the clinical setting and can have serious consequences. It is further complicated by the fact that it has multiple causes and patient symptoms can range from asymptomatic to death. considering the complexity and potential seriousness of hypokalemia, it is important that treatment be appropriate. DESCRIPTION OF THE PROCESS: The triangulated approach included an examination of the empirical evidence, a comparison of potassium protocols currently in use, and an evaluation of the potential benefits and risks of using a potassium protocol in a sample of patients. OUTCOME: There is wide variation in potassium protocols and no empirical evidence in support of or opposition to these protocols. An evaluation of the use of a potassium protocol in a sample of patients indicates that patients not on protocols are not being routinely treated according to general protocol potassium replacement recommendations. CONCLUSIONS: The use of narrowly defined potassium protocols may lead to overtreatment or incorrect treatment in the complex setting of hypokalemia. IMPLICATIONS FOR NURSING PRACTICE: Findings suggest the need for validation of clinically significant hypokalemia, the addition of other electrolyte measures when evaluating and treating hypokalemia, and the use of routine serum potassium levels and maintenance of serum potassium levels equal to or more than 4.0 mmol/L in certain patient populations. Most important, the etiology of hypokalemia, not used in qualifying criteria on any of the potassium protocols examined, should form the basis for treatment.
Program development: role of the clinical nurse specialist in implementing a fast-track postanesthesia care unit.
Advanced practice nurses are involved in many aspects of program development as part of their roles. This can involve such things as developing programs for staff and family education, organizing system-wide quality assurance programs, or implementing new care programs. One unique aspect of the advanced practice nurse's role is the ability to serve as a change agent and implement new models of care. Although all advanced practice nurses can be involved in program development, the role of the Clinical Nurse Specialist lends itself to devoting dedicated services for implementing programmatic change in the clinical setting. This article describes the role of the Clinical Nurse Specialist in implementing an evidence-based, fast-track postanesthesia care unit.