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Biomedical subjects

B Nelson

Publications and source records attributed to B Nelson.

171 records · Page 10Linked to original sources
PubMedDate not supplied

Feasibility of a music intervention protocol for patients receiving mechanical ventilatory support.

CONTEXT: Music has been found to be an effective nonpharmacologic adjunct for managing anxiety and promoting relaxation in limited trials of critically ill patients receiving mechanical ventilation. No data are available to determine the effect of the intervention over repeated trials or to determine whether patients or staff will use music intervention independently. OBJECTIVE: To test the feasibility of a patient-initiated music intervention protocol over a 3-day trial and to discern the associated barriers to adherence by study participants and nursing staff. DESIGN: Descriptive pilot study. SETTING: Two adult critical care units contained in 1 university-affiliated tertiary care center in the urban Midwest. PATIENTS: Five alert, critically ill adults receiving mechanical ventilatory support. INTERVENTION: Patient-selected music listening via audiotapes and head-phones with frequency and length of session determined by each patient. MAIN OUTCOME MEASURES: Anxiety, heart rate, respiratory rate, blood pressure, and identified barriers to protocol adherence. RESULTS: Subjects averaged 2 self-initiated music interventions (mode = 3; range = 1-5) and listened for an average of 67.8 minutes per session (SD 34.3; mode = 50; range = 25-120 minutes). Barriers to this intervention included inaccessibility of the equipment and lack of knowledge and experience of the nursing staff. Due to missing data, physiological measures were not interpretable. CONCLUSIONS: Patient-initiated music is a feasible intervention protocol: subjects were able to request music independently and nursing staff were cooperative. Findings will be used in future studies to refine the protocol and attendant measures to implement music intervention in the critical care setting and to develop detailed staff education materials.

Adult↗
PubMedDate not supplied

Emerging role of the pediatric nurse practitioner in acute care.

The pediatric nurse practitioner role in the tertiary setting is one of several emerging roles gaining recognition in the various groups of advanced practice nursing programs today. The advanced practice nurse (APN) who is a pediatric nurse practitioner (PNP) in an acute care setting helps to provide cost-effective, quality patient care for critically and chronically ill children who are in these settings. The foundation of advanced practice nursing in this role incorporates the general role expectations of advanced nursing preparation, including case management, clinical pathway development, consultation and education, research, and collaboration, with the specific knowledge and skills of the pediatric nurse practitioner to function effectively with sick children in the acute care areas.

Case Management↗
PubMedDate not supplied

Optimization of techniques in screening CT of the sinuses.

The number of screening examinations of the sinuses performed with CT has markedly increased owing to the widespread and increasing use of endoscopic sinonasal surgery. We reviewed scans from 500 patients who had screening CT examinations of the sinuses for preendoscopic evaluation of inflammatory sinonasal disease to better define an optimal imaging protocol. Three aspects of direct coronal imaging of the paranasal sinuses were investigated: (1) preparation of the patient prior to the examination; (2) technical factors of the CT study, including positioning of the patient, optimal coronal angle, slice thickness, and CT exposure factors; and (3) data display. Our experience indicates that pretreatment of the patient with maximal medical therapy enables the best preendoscopic definition of anatomy, disease pattern, and nonreversible disease component for the treating surgeon. CT technical factors are optimized with scanning in the prone position with thin (3-mm) sections obtained through the anterior paranasal sinuses. This allows optimal visualization of the ostiomeatal unit. The remaining posterior portions of the sinuses are adequately imaged with thicker slices (5 mm). The coronal scan angle used is less critical. Exposure factors (mAs) can be reduced dramatically without image compromise. Data display is optimized when the bone algorithm is used to acquire the data and with image display at intermediate window center and width level. Use of the techniques outlined in this article results in a cost-effective yet diagnostic scan of the sinuses with decreased radiation exposure to the patient.

Cost-Benefit Analysis↗
PubMedDate not supplied

Participation of nurse executives in product decisions.

This national survey of 30 chief nurse executives documented the significant product purchase power of these administrators. While nurse executives in small organizations tended to be involved in almost all product decisions, nurse executives in larger institutions focused on major hospital equipment purchases.

Administrative Personnel↗
PubMedDate not supplied

Restraining an aggressive suicidal, paraplegic patient: a look at the ethical and legal issues.

This paper focuses on a case of an intently suicidal, paraplegic patient in a critical care unit and the need for collaboration among nursing leaders to provide a safe environment through the use of wrist restraints. Ethical questions regarding patient rights, liberties, and privileges are reviewed. Legal points of negligence and intentional torts are also included in the analysis of the case.

Aggression↗