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Biomedical subjects

Audrey Nelson

Publications and source records attributed to Audrey Nelson.

33 records · Page 2Linked to original sources
PubMed2003

Preventing nursing back injuries: redesigning patient handling tasks.

The researchers identified nine patient handling tasks that place nursing staff at high risk for musculoskeletal injuries. An expert panel redesigned these tasks using new patient handling technologies and work practice controls. The key objective was to evaluate the biomechanical benefit of the redesigned tasks. Back and shoulder muscle activity, forces on the lumbar spine, shoulder joint moments, and perceived comfort were evaluated in a laboratory setting. Using objective and subjective data, 63 participants who performed the redesigned tasks were compared with 71 participants who used standard procedures. Objective data revealed significant improvement in five of the redesigned tasks, while staff subjectively rated four of the redesigned tasks as significantly improved. Nursing tasks can be redesigned to improve caregiver and patient safety using new patient handling technologies and work practice controls. Further study is needed to redesign other high risk tasks to promote safer work environments.

Back Injuries↗
PubMed2003

Fall-related fractures in persons with spinal cord impairment: a descriptive analysis.

Falls are a significant cause of injury, disability, and death in the elderly, but little is known about the risk of wheelchair-related falls. The purpose of this study is to describe the incidence, etiology, location of fracture, treatment, and health care utilization of fall-related fractures in persons with spinal cord impairment (SCI). A retrospective review of 45 medical records of patients with SCI who sustained fractures, nonconcomitant with the onset of their initial injury, was completed at a Veterans Health Administration (VHA) SCI service over a 10-year period. Of the 24 veterans who sustained fall-related fractures, three (12%) were found to have repeated falls with fractures. Falls were sustained during activities (more than one wheelchair activity contributed to a fall; e.g., transfer activity with brake failure in a van) including transfer (44%), reaching (11%), propelling (15%), moving in bed (22%), transferring or riding in a vehicle (30%), and showering (7%). Factors contributing to falls included loss of balance, equipment failure, muscle spasms, excessive speed, not wearing protective straps, and narcolepsy. Among the 31 fractures sustained in 27 fall episodes in 24 subjects, lower extremity fractures accounted for 97% of the injuries and a fractured 7th rib accounted for one injury (3%). Tibial fractures occurred more frequently than femoral or ankle fractures. Four (15%) fall episodes resulted in bilateral fractures. The treatment of choice was to immobilize the fractured extremity with a soft, well-padded splint. Surgical fixation was performed in only two cases. Over 80% of the patients with fall-related fractures were admitted for inpatient stays with a mean of 66 inpatient days per patient. Hospital days were most often the result of home inaccessibility, inadequate support at home, or surgical intervention.

Accidental Falls↗
PubMed2002

Data abstraction: designing the tools, recruiting and training the data abstractors.

Data abstraction is very exacting work requiring that data abstractors have both knowledge and experience of phenomena being studied. Quality of the data and efficiency of the data abstractors are dependent upon the content and design of the data abstraction tools. Taking the time to recruit and train qualified data abstractors and to develop effective data abstraction tools will result in data that not only answers the research question, but also withstands the most rigorous critique.

Abstracting and Indexing↗
PubMedDate not supplied

Modification of bed systems and use of accessories to reduce the risk of hospital-bed entrapment.

Despite the long history of hospital-bed use, only in the past decade have bed-related patient-safety hazards, including falls and life-threatening entrapment, been discussed publicly. Entrapment is an event in which a patient is caught, trapped, or entangled in hospital-bed components, including the bed rail, mattress, or hospital-bed frame. Since 1995, the Food and Drug Administration and the Joint Commission on Accreditation of Healthcare Organizations have issued patient-safety alerts about entrapment. While new beds are being manufactured without large gaps that would allow an individual's head, neck, or chest to become entrapped, it is incumbent upon healthcare providers, including rehabilitation nurses, to ensure the safety of older beds in use. This article describes a facility-based approach for identifying and managing risk related to hospital bed-entrapment to be used in rehabilitation settings.

Accident Prevention↗
PubMedDate not supplied

Wheelchair-related falls: current evidence and directions for improved quality care.

While much of the research on falls has focused on the ambulatory elderly, little is known about wheelchair-related falls that occur in persons with disabilities. A thorough understanding of wheelchair-related falls would include the demographics, the mechanism and nature of the fall event, and the nature of any resultant injury, including the cost of treatment and long-term sequelae. The purpose of this article is to provide an overview of the current data on wheelchair-related falls and to make recommendations for avenues for improved quality of care and future research to promote patient safety.

Accidental Falls↗
PubMedDate not supplied

Prioritizing safe patient handling: The American Nurses Association's Handle With Care Campaign.

Nurses continue to suffer debilitating injuries secondary to manual patient handling. Patient care ergonomics has emerged to redesign patient care with reduced exposure to physical hazards. Safe patient handling programs are being increasingly accepted by healthcare organizations to prevent occupational injury and to enhance patient safety. The authors discuss national-level efforts to promote patient care ergonomics principles and safe patient handling programs and their impact on nursing shortages and quality patient care.

American Nurses' Association↗
PubMedDate not supplied

A business case for patient care ergonomic interventions.

This article provides a framework for a business case for patient ergonomic programs that accentuates the financial gains to be realized from such programs as compared to meeting safety requirements. An introduction is made to such commonly used measures as payback period, net present value analysis and internal rate of return. Financial measures on a successful patient handling project in the Veterans Health Administration are outlined and policy implications discussed.

Cost-Benefit Analysis↗
PubMedDate not supplied

Evidence for implementing nonpharmacological interventions for wandering.

Wandering is among the most frequent, problematic, and dangerous comorbid behaviors in dementia or head injury. To summarize the emerging literature on nonpharmacological interventions used to control negative consequences of wandering, a systematic review of the literature was performed. The review included searching multiple electronic databases and hand searches of individual articles. The search yielded 31 articles that met established criteria. These articles then were classified into six categories: Subjective barriers, walking/exercise and other activities, specialized environments, behavioral techniques, music, and alarms. The literature varied widely in terms of theoretical soundness, methodological rigor, and clarity. The level of evidence supporting these interventions and implications for future study are discussed.

Behavior Therapy↗
PubMedDate not supplied

Inpatient mortality of hip fracture patients in the Veterans Health Administration.

Hip fractures among elderly people frequently result in permanent disabilities, nursing home placement, and death. The bulk of hip fracture research focuses on elderly women. Within the Veterans Health Administration (VHA), the majority of patients are men. There are no published national reports on hip fractures with large male samples, or on related inpatient mortality among veterans. This retrospective study of 13,546 veterans with hip fracture discharges from 1998-2002 found unadjusted mortality rates are higher in the VHA, compared with the general population. VHA patients tend to be older men in poor health who stay in the hospital longer Increased knowledge about the risks and outcomes associated with hip fractures in men could lead to improved primary and secondary injury-prevention programs. Rehabilitation nurses in acute care can be catalysts in proactively incorporating protective devices, screening for osteoporosis, and initiating lifestyle changes in their plans of care to optimize outcomes for hip fracture patients.

Aged↗
PubMedDate not supplied

Evidence-based practices for safe patient handling and movement.

Efforts to reduce injuries associated with patient handling are often based on tradition and personal experience rather than scientific evidence. The purpose of this article is to summarize current evidence for interventions designed to reduce caregiver injuries, a significant problem for decades. Despite strong evidence, published over three decades, the most commonly used strategies have strong evidence that demonstrate they are ineffective. There is a growing body of evidence to support newer interventions that are effective or show promise in reducing musculoskeletal pain and injuries in care providers. The authors have organized potential solutions into three established ergonomic solution types: engineering based, administrative, and behavioral. For each intervention, the level of evidence to support its use is provided.

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