Biomedical subjects

Susan Hazelett

Publications and source records attributed to Susan Hazelett.

5 recordsLinked to original sources

PubMed2004

Blood samples drawn from IV catheters have less hemolysis when 5-mL (vs 10-mL) collection tubes are used.

INTRODUCTION: It is common practice for emergency nurses to draw blood for laboratory analyses into vacuum tubes from newly inserted intravenous (IV) catheters, even though this technique has been associated with an increase in sample hemolysis. No clinical nursing studies have documented the effect of collection tube size on hemolysis of samples obtained via IV catheters. OBJECTIVE: To determine whether there is a difference in the hemolysis rate of blood samples drawn from IV catheters comparing 5-mL vacuum collection tubes to 10 mL vacuum collection tubes. SETTING: The study was conducted at the Emergency Department, Summa Health System, Akron, Ohio. Method This study used a 4-group, 2-period crossover design randomly assigning the order of the vacuum tube drawn. With the crossover design, each patient served as his own control. Upon receiving orders to start an IV and draw blood, each of 12 study nurses obtained an envelope with 2 vacuum tubes randomly assigned as to which tube should be drawn first and which tube should be drawn second. Samples were analyzed for hemolysis using a Hitachi automated spectrophotometer as well as by visual inspection. DATA ANALYSIS: A linear mixed model was used to test the main hypothesis of vacuum tube type effects on hemolysis. RESULTS: The 5-mL tubes showed significantly lower hemolysis than the 10 mL tubes ( P <.0001) with a substantial effect size of .6 standard deviation units. CONCLUSION: The risk of hemolyzing blood drawn from IV catheters can be significantly reduced by using 5-mL rather than 10-mL collection tubes.

Blood Specimen Collection↗

PubMed2004

A strategy to decrease the use of risky drugs in the elderly.

Many medications that are safe in most patients pose serious risks in older patients, including functional decline, delirium, falls, and poorer outcomes. We describe our institution's program of "academic detailing," designed to reduce the use of three high-risk drugs in elderly patients.

Aged↗

PubMed2003

Ensuring success: research by committee.

The Nursing Research Committee at a community teaching hospital conducted a research study on alternatives to restraints in a confused population. The authors describe the process this committee used to successfully conduct the study, from starting a research focus group and setting goals to choosing a research topic, designing the study, and collecting data. Critical success factors for completing research by committee are described.

Confusion↗

PubMed2002

Patients' behavior at the time of injury: effect on nurses' perception of pain level and subsequent treatment.

This study examined whether nurses who currently provide direct patient care would perceive and treat pain differently in patients whose pain resulted from activities involving different levels of socially acceptable behavior. Clinical vignettes (differing only with respect to information provided about the patient's behavior at the time of injury) were randomly distributed to all medical/surgical, critical care, and emergency room nurses at this institution. Nurses were asked to record their perception of the patient's pain level and to indicate how much morphine should be given. Nurses (n = 167) did not differ significantly in their mean pain ratings (p =.86) or in the average amount of morphine (p =.80) given to the 2 patients. However, medical/surgical nurses indicated that they would give significantly less morphine to the patient who was presented as engaging in less socially acceptable behavior at the time of injury (p =.03). Overall, significantly more nurses correctly increased the next dose of morphine for the patient who was presented as having injured him or herself while participating in more socially acceptable behavior (p =.003). Thus, although the level of social acceptability of the patient's behavior at the time of injury did not significantly affect the average pain rating or morphine dose that the nurse would have reportedly given, there is evidence that the nurses would have been less aggressive in ensuring adequate pain treatment in the patient exhibiting less socially acceptable behavior.

Attitude to Health↗

PubMedDate not supplied

A pilot study: post-acute geriatric rehabilitation versus usual care in skilled nursing facilities.

OBJECTIVES: To compare discharge outcomes, postdischarge health care use, and death rates among patients treated in a postacute geriatric rehabilitation unit (GRU) housed within a skilled nursing facility (SNF) with those treated in a traditional SNF. DESIGN: Retrospective observational pilot study. SETTING: Two similar SNFs were compared. PARTICIPANTS: All patients were admitted from the acute hospital to either the GRU (n = 95) or to the usual care (UC) SNF (n = 55). INTERVENTION: The GRU intervention consisted of comprehensive geriatric assessment and weekly interdisciplinary team rounds with a geriatrician and a geriatric nurse practitioner (GNP). The geriatrician visited the GRU twice a week and the GNP was present 4 to 5 times per week. On discharge, GRU patients were followed up with telephonic case management for 1 year. MEASUREMENTS: Demographic data collected included age, gender, and race. Information collected from each facility's patient records included admitting diagnosis, length of stay, discharge disposition, and functional outcomes. Emergency department (ED) visits and hospital readmissions for 1 year after discharge from the nursing facility were obtained from our institutional database. The Rehabilitation Outcome Measure (ROM) was used by each facility to measure functional status on admission and at the time of discharge. RESULTS: Baseline patient characteristics were comparable between the 2 facilities. At discharge from the nursing facility, GRU patients showed greater improvement in ADLs and mobility, had a significantly shorter length of stay, and were discharged to home more often. At 1 year, GRU patients had significantly fewer hospital readmissions. GRU patients also had fewer ED visits and days in the hospital at 1 year, however these results were not significant. CONCLUSION: These pilot results suggest that GRU may be an effective means to improve patient outcomes and reduce undesirable health care use after an acute illness. Further studies using a randomized design are needed.

Activities of Daily Living↗