Search PubMed⌕ Search

Biomedical subjects

B Olson

Publications and source records attributed to B Olson.

At least 55 records · Page 3Linked to original sources
PubMed1984

Pseudomonas in the sinks in an intensive care unit: relation to patients.

Sink drains in a medical-surgical intensive care unit (ICU) were cultured during six consecutive weeks as part of a seven month prospective study of acquisition of Pseudomonas aeruginosa by ICU patients. Isolates were typed serologically and by aminoglycoside and chlorhexidine susceptibility patterns. All 11 sinks contained multiple strains of P aeruginosa; some strains persisted for weeks while others were isolated once. Of the sink isolates 56% had high level resistance to gentamicin and tobramycin whereas none of the strains found in patients. In sink isolates chlorhexidine resistance correlated with aminoglycoside resistance and with the presence of a chlorhexidine dispenser at a sink. The sequence of recovery of phenotypically similar isolates suggested that sinks were the source of at most two acquisitions of P aeruginosa by patients during the six weeks. Our study confirms that sinks may be reservoirs for large numbers of highly resistant P aeruginosa but are rarely the source of organisms colonising patients in our ICU.

Aminoglycosides↗
PubMed1983

Employee rubella screening programs in Arizona hospitals.

One year after voluntary guidelines on rubella screening of hospital employees were issued by the Arizona Department of Health, a survey of 68 members of the Arizona Hospital Association was conducted, with an 81% response. Some form of employee rubella screening was present in only 49% of responding hospitals. Of the screening hospitals, 70% of programs had a mandatory aspect for selected employees. Administrative logistics, cost, problems encountered, and the quality and coverage of the program varied substantially among the different hospitals. Fewer than half of the screening hospitals had programs for physicians, students, or volunteers. Verbal histories of immunization or serological tests, although notoriously unreliable, were accepted by 14% of the screening hospitals. Half of the nonscreening hospitals plan to implement programs in the future. Reasons given for not establishing rubella screening programs include cost, no pediatric or obstetric service, liability issues, high turnover, and no previous case of rubella in an employee. Three hospitals (all screening) reported they had had a case of rubella in an employee. The data suggest slow partial compliance with recommendations for rubella screening in hospitals.

Adolescent↗
PubMed1983

Broad-spectrum beta-lactam resistance in Enterobacter: emergence during treatment and mechanisms of resistance.

Of three patients with Enterobacter mediastinitis treated with cefamandole, two failed initial treatment due to emergence of strains resistant to cefamandole and third generation cephalosporins. Extracts of the sensitive strains showed inducible hydrolysis of cephalothin; resistant strains (wild and laboratory derived) showed constitutive hydrolysis of cephalothin and cefamandole and bound but did not hydrolyze cefotaxime and latamoxef (moxalactam). In one mutant, increased latamoxef resistance appeared due to non-enzymatic mechanism(s). The Enterobacter strain from the patient who was treated successfully with cefamandole yielded only low level resistant mutants with lower cephalosporin binding than obtained with the other strains.

Anti-Bacterial Agents↗
PubMed1981

Non-cardiogenic pulmonary oedema. A serious complication of transurethral prostatectomy. A case report.

A patient undergoing prostatectomy under epidural analgesia developed clinical signs of a severe TURP syndrome. During resuscitation, it was revealed that serum sodium was only moderately decreased. Plasma oncotic pressure was, however, markedly decreased and the pressure gradient between plasma oncotic pressure and pulmonary capillary wedge pressure (approximately hydrostatic pressure) was 1 mmHg (0.13 kPa) only, allowing almost free filtration of fluid through the pulmonary capillary wall, resulting in a non-cardiogenic pulmonary edema. The patient was successfully resuscitated with albumin and inotropic stimulation with prenalterol.

Aged↗
PubMed1978

A survey of drug use among probationers in the Los Angeles area in 1976.

The results are presented from the analysis of 10,000 urine specimens from Los Angeles County probationers in early 1976 for the following drugs: amphetamine, methamphetamine, allylbarbital, amobarbital, butabarbital, pentobarbital, phenobarbital, secobarbital, morphine, codeine, methadone, primary metabolite of methadone, cocaine, benzoylecgonine, propoxyphene, norpropoxyphene, methaqualone, and phencyclidine. Over 27% of the urine samples analyzed were positive for at least one drug. Opiates were found to be the most widely used drugs, but multiple drug use was also quite common.

California↗
PubMed1978

Dieldrin, DDT, PCBs, and mercury levels in freshwater mullet from the upper Great Lakes, 1975-76.

Freshwater mullet harvested commercially during various seasons of 1975-76 from the upper Great Lakes were analyzed for organochlorine pesticides, PCBs, and mercury. Species analyzed were Catostomus commersoni, C. catostomus, and Moxostoma erythruran. Whole ground fish, mechanically deboned flesh, head, middle, and tail steaks, and various muscles were analyzed for pesticides and PCBs; only edible flesh was analyzed for mercury. Dieldrin ranged from none detected to 0.23 ppm in deboned and whole ground samples, the DDT range was a trace to 0.30 ppm, and PCBs ranged from 0.06 ppm to 0.79 ppm. Levels were also higher in head sections and in high fat-containing medial muscle and belly flap. Mercury levels ranged from 0.03 ppm to 0.28 ppm in the flesh of mullet from Lake Michigan.

Animals↗
PubMedDate not supplied

Pressure ulcer prevalence and incidence in a rehabilitation hospital.

Pressure ulcers remain a serious health problem, especially in terms of personal suffering and economics. The study described here, conducted in a rehabilitation setting, investigated the prevalence (number of persons with pressure ulcers at a given time) and the incidence (number of persons developing pressure ulcers over a given time) of pressure ulcers. Skin assessments and risk assessments of the subjects were completed using the Braden Scale for Predicting Pressure Sore Risk. Demographic data were obtained. The prevalence rate was 25%, although there was no incidence during the time of this study. Factors associated with the prevalence of pressure ulcers are discussed.

Adult↗
PubMedDate not supplied

The effectiveness of skin care protocols for pressure ulcers.

Pressure ulcers (PU) remain a serious healthcare problem in the United States. This study investigated the effectiveness of a prevention and early intervention program in reducing the prevalence of pressure ulcers (i.e., the number or the percentage of persons with pressure ulcers at a given time) in a rehabilitation hospital. The Braden Scale for Predicting Pressure Sore Risk was used to assess subjects' PU risk. Protocols were established for PU stages consistent with the National Pressure Ulcer Advisory Panel consensus statement on pressure ulcers. Staff were educated about PUs and the specific protocols for prevention and treatment. Concurrent quarterly prevalence audits on a total of 116 patients were conducted for 1 year. An audit also was done 16 months after protocols had been established. There was a 60% decrease in pressure ulcer prevalence from the 25% baseline to the 10% found at the audit following implementation of the protocols.

Aged↗
PubMedDate not supplied

The patient in a halo brace: striving for normalcy in body image and self-concept.

This retroactive descriptive study identified specific psychologic concerns and needs of halo patients related to the halo experience. Thirty-eight subjects who had a halo brace applied in the previous 8 years completed the questionnaire. Responses were categorized and analyzed using nursing diagnoses. Results showed that distortion of body image, distortion of self-concept, grieving for losses, and striving for normalcy are among the phenomena experienced by halo patients.

Adaptation, Psychological↗
PubMedDate not supplied

Variables associated with hypotension in postoperative total knee arthroplasty patients receiving epidural analgesia.

The purpose of the study was to identify variables that may place the total knee arthroplasty patient receiving epidural analgesia at risk for hypotension postoperatively. A review of medical records of this convenience sample of 99 subjects was conducted in this retrospective, descriptive, correlational study. Variables predictive of postoperative hypotension using stepwise multiple regression included low postoperative systolic BP on the nursing unit the day of surgery (R2 = .26, p less than .001), low diastolic BP in postanesthesia room (R2 = .31, p less than or equal to .01), low hemoglobin the third postoperative day (R2 = .37, p less than or equal to .01), use of diuretics preoperatively (R2 = .40, p less than or equal to .05), and total fluid intake first day postoperatively (R2 = .43, p less than or equal to .05). These variables accounted for 43% of the variability in the occurrence of hypotension. Identification of variables predictive of hypotension should provide direction for future care givers and researchers.

Adult↗
PubMedDate not supplied

Comparison of 2 wound volume measurement methods.

OBJECTIVE: To compare 2 wound volume measurement techniques, the Kundin device and stereophotogrammetry, on 2 wound shapes. DESIGN: Using 2 wound measurement techniques, the interrater and intrarater reliability and the bias and standard error of measurement of an L-shaped and a pear-shaped plaster of paris wound model were assessed. SETTING: A clinical laboratory of a school of nursing. PARTICIPANTS: Twenty-four raters, all but 2 being registered nurses, measured each of the wounds using both techniques. INTERVENTIONS: Each rater measured each wound twice using each method in a randomly assigned order defined on a card that was drawn from a box. Measurements were recorded on a researcher-designed data collection form, which included some demographic data related to each participant. MAIN OUTCOME MEASURES: The study hypothesis was that there would be no significant difference in accuracy between the 2 wound volume measurement methods. RESULTS: The least biased and most accurate technique was stereophotogrammetry, with the smallest standard of error of measurement. Interrater reliability of average ratings was identical for both methods at 0.98. For single ratings, stereophotogrammetry was slightly higher than the Kundin device. Intrarater reliability was higher on the pear-shaped wound for the Kundin device, which had lower interrater reliability, suggesting that nurses were consistent in the direction and size of personal error. Intrarater reliability for stereophotogrammetry was identical to that of the Kundin device for the L-shaped wound and lower for the pear-shaped wound. CONCLUSIONS: Although both techniques have acceptable accuracy, stereophotogrammetry is more accurate and has more clinical applications.

Adult↗
PubMedDate not supplied

The prevalence and incidence of pressure ulcers in the hospice setting: analysis of two methodologies.

Hospice patients may be at greater risk of pressure ulcer development than most patients. This descriptive study explored the prevalence and incidence of pressure ulcers in the hospice setting, utilizing both a prospective and retrospective methodological approach. Levine's theory of the four principles of conservation formed the theoretical basis for the study, and the Braden Scale for Predicting Pressure Ulcer Risk was used for data collection. Prevalence of pressure ulcers was noted to be 13 percent in the study. Incidence of pressure ulcers was found to be zero percent using prospective methodology and 13 percent using retrospective methodology. Five of eight ulcers (62 percent) occurred within two weeks of patient death. Factors related to pressure ulcer development are presented, as well as a discussion of using research methodologies in the hospice setting. The article suggests the need for preventive protocols for skin care for patients who are at risk for pressure ulcer development.

Female↗
PubMedDate not supplied

Evaluation of pressure ulcer prevalence rates for hospice patients post-implementation of pressure ulcer protocols.

Hospice patients may be particularly at risk for pressure ulcer development due to several factors. Identifying populations at risk for pressure ulcer development, such as hospice patients, and providing prevention and risk protocols for these populations can substantially reduce the prevalence and incidence of pressure ulcers. However, are hospice patients prone for skin breakdown despite prevention and treatment efforts? This study examines the prevalence of pressure ulcers in hospice patients following the implementation of pressure ulcer prevention and treatment protocols. Levine's theory of conservation of structural integrity formed the theoretical framework for this descriptive study. A midwestern hospital-based hospice agency was the site for this study. All patients 18 years of age and older were included in the study. Pressure ulcer prevalence audits were done at four, eight, 12, and 18 months after protocols were outlined by the hospice staff. Results of the audits revealed prevalence rates of 14.8 percent, 8.5 percent, 13.6 percent, and 23.8 percent, at each of the aforementioned audits. 10 of 15 patients who were pressure ulcer positive were males; the sacral location was most common (seven of 19 ulcers occurred sacrally) with the ischial location being the next common (six of 19 ulcers were ischially located). No ulcers occurred above the waist or in patients below 51 years of age. Recommendations from this study urge that particular prevention attention be given to protocols which address "sitting," due to the predominance of ulcers located in the sacral and ischial regions. In addition, the author concludes that perhaps, pressure ulcers may occur in this population despite the best of efforts to prevent them.

Aged↗
PubMedDate not supplied

Two-dimensional wound measurement: comparison of 4 techniques.

Two- and three-dimensional wound measurement techniques are documented in the literature and used clinically, as well as in research. The purpose of this study was to compare 4 two-dimensional wound measurement techniques: linear length and width using a ruler, planimetry, computerized stereophotogrammetry (SPG) length and width, and computerized SPG area. Three plaster of Paris wound models were developed and baseline measurements of outer wound perimeters obtained via a Coordinate Measuring Machine. The convenience sample of raters included 66 upper-division baccalaureate nursing students, graduate nursing students, nursing staff, and wound care nurses. Each rater measured each wound twice in a randomly assigned order of methods written on a card drawn from an envelope. The least biased technique was the computer area, followed in order by the computer length and width, planimetry, and ruler length and width. The most accurate technique, given multiple raters, was determined by the standard error of measurement. The smallest standard error of measurement, thus the most accurate, was the computer area technique, followed in order by the ruler length and width, computer length and width, and planimetry. Interrater reliability of average ratings was high; only the SPG area measurements for single ratings were reliable enough for clinical or research purposes. Intrarater reliability was high for methods with low interrater reliability, suggesting that nurses are consistent in the direction of personal error.

Adult↗
PubMedDate not supplied

Clinical evaluation of an automated turning bed.

PURPOSE: The purposes of this study were to assess client comfort and sleep quality, client physiologic response (skin and respiratory status), the effect on the need for caregiver assistance, and cost when using an automated turning bed. DESIGN: Nonexperimental, evaluative study. SAMPLE: Twenty-four adult home or long-term care resident subjects who had a degenerative disease, spinal cord injury, stroke, cerebral palsy, or back surgery. METHODS: Each subject agreed to use the automated turning bed for four weeks. Researchers completed a demographic survey and skin assessment, and assessed each subject for pressure ulcer risk and for the need of assistance of a care giver for turning before and after the four weeks of using the turning bed. Subjects rated the turning bed in terms of comfort and sleep quality. FINDINGS: Subjects rated the turning bed as more comfortable than their own bed and expressed satisfaction at the pain relief attained when on the turning bed. While using the turning bed, there was a significant improvement in sleep quality. No skin breakdown or deterioration in respiratory status occurred. Fewer subjects required the assistance of a caregiver for turning when on the turning bed. CONCLUSION: This automated turning bed shows great promise in meeting a need for patients with limited mobility whether they are homebound or in a residential community. IMPLICATIONS FOR NURSING RESEARCH: Future studies that further investigate use of the turning bed for postoperative back patients while still in the acute care setting are indicated. Replicative studies with a larger sample size are also indicated.

Adult↗