Biomedical subjects

R Ludwick

Publications and source records attributed to R Ludwick.

21 records · Page 2Linked to original sources

PubMedDate not supplied

Assessment of the geriatric orthopaedic trauma patient.

Elderly clients may suffer orthopaedic trauma from falls, motor vehicle accidents, abuse, or crimes. Falls are the most common reason for orthopaedic injury. While these same traumas occur in the young, older adults may not have the physiologic reserves necessary to promote healing or to prevent or recover from complications. Injuries sustained from trauma in combination with physiologic changes and comorbidity in the aged make orthopaedic trauma a significant health problem in older adults and a major treatment challenge. This article discusses diversity issues, physiologic changes, and assessment of the elderly that will help guide the orthopaedic nurse in providing care to elderly patients who experience orthopaedic trauma.

Activities of Daily Living↗

PubMedDate not supplied

Relatives' perceptions of side rail use on the older person in hospital.

With an increasing emphasis on improving standards in the care of older people, the use of physical restraints has received growing attention in the nursing literature. Physical restraint use has been likened to abuse as it impedes the movement of a person, encourages dependence on staff and denies autonomy. Side rails (cot sides, bed rails) can be considered as a physical restrain device. The therapeutic use of restraint has not previously been adequately explained. Furthermore, there is a dearth of literature examining the personal experience of physical restraint use. The Family Interview Guide (Strumpf and Evans, 1988) was used to explore perceptions of nine relatives whose family had side rails used during their care in an older person ward. The findings of the study suggest that while families place value on the perceived safety function of side rails, they nonetheless have worries about their use. These pertain to the risk of patient entrapment and possible injury. Patients' relatives associated side rails with ritualized practice in gerontology and make suggestions for the re-design of side rails. The study also highlights the potential for increased family participation in the decision to use side rails.

Accidental Falls↗

PubMedDate not supplied

Clinical decision making: recognition of confusion and application of restraints.

PURPOSE: The purpose of this study was to test the effects of patients' social, behavioral and medical characteristics on nurses' clinical decision for patient confusion. DESIGN: Factorial survey. METHODS: A random sample of 100 registered nurses scored 30 unique situation based vignettes on the likelihood the patient described was confused and whether restraints should be used. Every vignette contained a combination of eight independent patient variables: age; gender; race; patient affect; type, seriousness and time of patient act and medical diagnosis. FINDINGS: Examination of the recognition model and the intervention (applying restraints) models showed that patient variables explained approximately 40% and 43% of the variance respectively. Type of act, seriousness of act, time of act, and patient age all significantly increased nurses identifying patients as confused. The variables that were strong predictors for recognizing confusion were strong predictors for restraint use except that patients who exhibited a negative affect were more likely to be restrained than patients' who were portrayed as pleasant. CONCLUSION: Confusion is a complex clinical phenomenon with many dimensions. Confusion tools should be standardized and routinely used.

Adult↗