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Biomedical subjects

M Hickey

Publications and source records attributed to M Hickey.

17 recordsLinked to original sources
PubMed1991

Competence statements for differentiated nursing practice in critical care.

The demand for high-quality patient care in the current complex health care environment and the variety of today's available nursing education programs dictate a need to differentiate nursing practice into technical and professional roles. These roles are based on competencies acquired in ADN and BSN degree programs and implemented in practice settings where the contributions of all nurses are valued. To create a preferred future, AACN has developed a model for differentiated nursing practice in critical care. The model is a guideline for those nurses and institutions who may be or will be involved in changing practice patterns. The model does not support or encourage the elimination or disenfranchisement of any individual or groups of nurses. These statements were developed to address specific behavior that reflects the valuable contributions of each category of nurses within critical care nursing. The statements provide a model for creating efficient and effective practice patterns that may contribute to high-quality outcomes for critically ill patients and their families.

Clinical Competence↗
PubMed1990

Encephalitis due to Epstein-Barr virus.

Acute encephalitis due to Epstein-Barr virus is described. The initial diagnosis was based on clinical features and a positive Monospot test. Early treatment with intravenous acyclovir was given; steroids were not used. The patient made a rapid and complete recovery from a comatose state. The effectiveness of acyclovir in this condition remains unproven but early treatment is recommended in severely ill patients whose prognosis is uncertain.

Acyclovir↗
PubMed1990

What are the needs of families of critically ill patients? A review of the literature since 1976.

The research conducted on families' needs in critical care was reviewed to summarize the findings for practice and recommend future directions for research on this topic. A literature search yielded eight articles in which replicable primary research on the needs of families of critically ill patients was reported. These reports, although individually limited by small sample size, presented similar findings. Families rated information needs most important, followed by needs for reassurance and convenience. Strategies to enhance information to families, such as written information, daily contact with physician or nurse or both, and establishing a nurse contact person for families and a family contact person who can be called about changes in patient status, are presented. Recommendations for future research include the study of elderly and male family members and tests of interventions aimed at meeting families' needs.

Adolescent↗
PubMed1990

The changing epidemiology of diabetes mellitus among Navajo Indians.

Although early descriptions of diabetes mellitus among Navajo Indians characterized the disease as an infrequent and "benign chemical abnormality," the prevalence of diabetes and its complications among Navajos appears to have increased substantially in this century. We reviewed recent Indian Health Service inpatient and ambulatory care data and compared these data with previous reports. Of the estimated Navajo population aged 45 years or older, 4,331 (16.9%) had an ambulatory care visit for diabetes between October 1, 1986, and September 30, 1987. Diabetes was coded for 1,041 (7.0%) of hospital admissions of persons aged 20 and older. Of 377 lower-extremity amputations done from 1978 to 1987, diabetes was involved in 245 (66%). The 1986 age-adjusted mortality rate from diabetes was 30.3 per 100,000, approximately twice that for the general US population. The explanation for the increased prevalence of diabetes mellitus among Navajos probably relates to an increasing prevalence of obesity.

Adult↗
PubMed1990

The role of the clinical nurse specialist in the research utilization process.

The goal of nursing research is to generate new information for the profession. Ideally, research findings validate clinical practice, and practice provides direction for research. Currently, there is a gap between knowledge generation through research and use of research findings in practice. This paper presents a model of research utilization which identifies the clinical nurse specialist's role in implementing the research utilization process in clinical practice.

Clinical Nursing Research↗
PubMed1990

Calcium metabolism in postpartum lactation: the effect of estrogen status.

Postpartum lactation represents a unique state of increased calcium demand in which women are also hyperprolactinemic and hypoestrogenic. This is associated with increased calcium mobilization from bone and bone loss. To better understand the effect of estrogen (E) status on calcium metabolism during lactation, we studied 10 long-term lactating women at 12 weeks postpartum when they were hypoestrogenic and again at 37.4 +/- 3.4 (+/- SD) weeks during the midfollicular phase of their second ovulatory cycle. Urinary and serum markers of calcium metabolism were measured at these intervals. The results revealed that when E was low, osteocalcin and hydroxyproline were increased with a lower circulating parathyroid hormone (PTH) level, whereas reciprocal changes were noted when E was increased. The findings suggest that E status can modulate PTH's ability to mobilize one's stores of calcium.

Adult↗
PubMed1988

Critical care nurses' role with families: a descriptive study.

The purpose of this descriptive study was to explore the topic of families of critically ill patients from the critical care nurse's perspective. Two hundred twenty-six critical care nurses from one Midwest and three New England hospitals participated in the study. Critical care nurses' responses to questions about family visiting demonstrated variation in their interpretation and enforcement of visiting policies within units and among hospitals. There was overall consensus that family members should play a supportive, although nonparticipative role in the provision of care of their sick family member. More than 75% of the critical care nurses became involved with families in need of emotional support although more than one third of the respondents did not believe they had the requisite knowledge to meet families' psychosocial needs. Among the factors that most influenced critical care nurses' involvement with families were situations relating to the patient's actual or impending death and the nurses' subjective feelings (likes or dislikes) for the patient and family.

Attitude of Health Personnel↗
PubMed1986

Interferon therapy for condylomata acuminata.

Current therapy for condylomata acuminata (genital warts) is not consistently effective. Therefore, we conducted a randomized, double-blind trial to compare interferon alpha-2b with placebo in the treatment of this disorder. Our rationale was that interferon has both antiproliferative and antiviral properties. The placebo or interferon (1 X 10(6) IU) was injected directly into one to three warts three times weekly for three weeks. The injections were well tolerated by both groups of patients. The side effects of fever, chills, myalgia, headache, fatigue, and leukopenia occurred more commonly in the interferon group than in the placebo group, but such effects rarely disrupted daily routines. Only 13 of 296 patients (4 percent) discontinued therapy because of side effects (11 in the interferon group and 2 in the placebo group). Twenty-six other patients were excluded from analysis because of a loss to follow-up or other deviations from protocol, thus leaving 257 patients in the final evaluation. At one week after the completion of therapy, interferon had produced a large and significantly greater reduction in mean wart area (a 62.4 percent decrease), as compared with placebo (a 1.2 percent increase in mean area) (P less than 0.001). At the conclusion of the study (13 weeks after the completion of therapy), the mean wart area was still decreased 39.9 percent below the initial size in the interferon group, whereas it had increased by 46 percent over base-line measurements in the placebo group (P less than 0.001). At the same time, all treated warts had completely cleared in 36 percent of the interferon recipients and in 17 percent of the placebo recipients (P less than 0.001), whereas treated warts progressed in 13 percent of the interferon recipients and in 50 percent of the placebo recipients (P less than 0.001). We conclude that injection of interferon alpha-2b directly into genital warts appears to be an effective and fairly well-tolerated form of therapy.

Adolescent↗
PubMedDate not supplied

Maintaining clinical excellence in a weekend alternative program: the role of the divisional clinical manager.

Many innovative management changes designed to promote clinical excellence and scholarship were undertaken by the nursing executive team at our 821-bed tertiary care teaching hospital. Included in these changes was the creation of the divisional clinical manager (DCM). The purpose of this article is to describe how these weekend managers employees contribute to the overall objectives of providing consistent supervision, clinical support and a rich continuing education program.

Consultants↗