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Biomedical subjects

N Geddes

Publications and source records attributed to N Geddes.

At least 19 recordsLinked to original sources
PubMed2000

The role of fibreoptic laryngoscopy in infants with stridor.

Stridor in infants may be potentially serious and would require further investigations in all cases. Laryngomalacia is the most common cause of congenital stridor. This is a self-limiting condition with a good prognosis but other causes of stridor should be excluded to enable the surgeon to plan further intervention if needed. Traditionally microlaryngoscopy and bronchoscopy under a general anaesthetic is performed to evaluate the airway. We have investigated the use of the flexible fibreoptic laryngoscope under local anaesthetics in infants with inspiratory stridor. The procedure was performed in the day surgery unit on a non-fasting, non-sedated child. A retrospective analysis of procedures performed between January 1998 and August 1999 was carried out. Of the 43 patients studied, laryngomalacia was diagnosed in 35, vocal cord palsies in six and two infants had a normal larynx. There were no complications during the procedure and only one child required further intervention. The results showed that the combination of fibreoptic laryngoscopy under local anaesthetic with follow-up is a safe, effective and cost effective method of assessing stridor in this group of patients.

Ambulatory Care↗
PubMed1999

Nursing in the nineties: managing the uncertainty.

OBJECTIVE: This study examined qualitative data on nurses' work lives from 53 hospitals that participated in the National Institutes of Health (NIH)-funded Outcomes Research in Nursing Administration Project (ORNA). BACKGROUND: The ORNA project examines the impact of nursing unit organizational structure on outcomes. The information reported in this article amplifies the quantitative data with qualitative data that enhances understanding of nurses' work lives. METHODS: Site coordinators at all participating hospitals were requested to send monthly journal entries for 6 months. Data were documented according to an agreed-on content outline that consisted of critical incidents and implications. Data were collected from 53 of the 65 study site coordinators (response rate 81.5%). Content analysis of all collected data was conducted by the research team. RESULTS: Study site coordinators in 53 hospitals characterize the acute care environment as turbulent and uncertain. Contributing factors include: 1) work load (fluctuating census, staff preparation, turnover); 2) loss of workplace identity (unit consolidation, hospital buy-outs, and system mergers); and 3) re-engineering (skill mix, new equipment/system changes, new documentation systems, rumored changes). CONCLUSIONS: This study adds to the growing body of literature that portrays environmental uncertainty from the narrative perspective. Although there is an ongoing need for the employment of fiscally accountable, quality enhancing organizational/management strategies, all initiatives are at risk unless personnel needs are attended to and seen as unique in each care setting. Some strategies are offered to meet this dual imperative.

Attitude of Health Personnel↗
PubMed1997

Nursing and alternative medicine. Legal and practice issues.

The burgeoning interest in alternative medicine in the past decade has created a demanding health care climate for professional nursing. Rising consumer consciousness and the cost of traditional Western medicine have together influenced an environment in which individuals and payers seek low-cost, high-value remedies. This article presents a definition of alternative medicine and an overview of related research initiatives. In addition, legal and practice considerations for professional nursing are discussed. The language of current nurse practice acts neither prohibits nor actively promotes alternative medicine practices. However, differences in the regulation of health care professionals, specifically physicians and nurses, create challenges for nurses as they respond to both consumer demand and the need for consumer protection, and work with physician colleagues in alternative medicine. Accompanying these challenges is the need to protect nurses' regulatory freedom and autonomy.

Attitude to Health↗
PubMed1997

Outcomes research. Clues to quality and organizational effectiveness?

Outcomes research has often been touted as the best response to concerns about quality in today's health care organizations. Yet, outcomes research is accompanied by its own set of problems. These problems must be addressed if outcomes research is, in fact, to guide assessments of quality and of organizational effectiveness. One question is how quality and organizational effectiveness should be defined. In addition, measurement issues are particularly problematic in outcomes research, as is the availability of appropriate data. This article discusses each of these areas, and concludes by presenting an integrated model to guide the assessment of outcomes, quality, and organizational effectiveness.

Data Collection↗
PubMed1994

The clinical ladder. Impact on nurse satisfaction and turnover.

Nurse administrators have advocated clinical ladder programs to address salary compression of experienced nurses. However, few clinical ladder programs have survived the test of time. One possible explanation for the demise of these programs is the failure to assess nurses' satisfaction with clinical ladder programs. Ongoing assessment of these programs may provide a solution to early demise.

Adult↗
PubMed1990

Nutrient intakes, vitamin-mineral supplementation, and intelligence in British schoolchildren.

Children (227), aged 7-12 years, weighed and recorded all food and drink consumed for seven consecutive days. Each child completed tests of verbal and non-verbal intelligence, and was then randomly allocated to one of two groups after matching for age, sex, IQ and height. In a double-blind trial lasting for 28 d, one group received a vitamin-mineral supplement daily and the other group a placebo. On re-testing, there were no significant differences in performance between the two groups. Furthermore, there was no consistent correlations between test scores and micronutrient intakes based on the weighed records. Thus, we found no evidence that learning ability in a cross-section of British schoolchildren was limited by the quality of their diets.

Body Height↗
PubMed1975

Ruptured iliac aneurysms.

Iliac aneurysms are uncommon as compared with aneurysms of the abdominal aorta. Rupture is the most serious complication of aneurysms of both vessels. Considerable attention has been focused on the management of ruptured abdomonal aortic aneurysms, but ruptured iliac aneurysms have received little notice. The problems in the management of ten ruptured iliac aneurysms, seen over the last five years, together with the rarity of other reports of this condition, have stimulated this review.

Aged↗
PubMedDate not supplied

The Outcomes Research in Nursing Administration Project: methodological issues in implementation.

This article describes the Outcomes Research in Nursing Administration (ORNA) project--a longitudinal, multisite study investigating the interrelationships of various hospital-level and nursing-unit-level characteristics, nursing unit organizational structure, and administrative and patient outcomes. A variety of methodological challenges were encountered in the actual conduct of the project in relation to the design, sampling plan, management of attrition, and data collection. The article describes these challenges and how they were successfully resolved.

Data Collection↗