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Biomedical subjects

C Moffatt

Publications and source records attributed to C Moffatt.

15 recordsLinked to original sources
PubMed1998

Collaboration in improving care for patients: how can we find out what we haven't been able to figure out yet?

BACKGROUND: Questions, or what the physicist and learning expert Reginald Revans called "insightful inquiry," are essential to learning. People remember and use what they discover themselves. But many habits and activities in front-line workplaces of patient care have not promoted frank discussions of what we haven't figured out yet about improving care for patients. Leaders are no longer defined by having the right answers. Leaders will be the ones who have the right questions and who promote local learning with the right questions. SUGGESTIONS FOR GETTING STARTED IN COLLABORATION. The authors suggest questions to ask to get collaborative inquiry going and cite examples they have collected. The questions and examples are grouped in seven thematic categories: Listening to and appreciating others; Thinking across disciplines and roles; Sharing ideas and linking those shared ideas to execution and deployment of change; Appreciating systems and interdependencies; Using research (including local research) to inform our practices; Using methods, skills, and techniques as facilitators of collaboration; and Working across organizational boundaries.

Communication↗
PubMed1998

The principles of assessment prior to compression therapy.

This article focuses on the type of assessment frequently performed by nurses although the patient with a leg ulcer requires the skills of the whole health-care team. A priority of assessment is to determine the underlying aetiology of the leg ulcer, but the assessment process is often complicated by the multifactorial health needs of this vulnerable group of older patients.

Bandages↗
PubMed1995

Ankle pulses are not sufficient to detect impaired arterial circulation in patients with leg ulcers.

Much debate has taken place on the use of Doppler ultrasound in the community setting. A sequential study of patients attending a community ulcer clinic was undertaken to identify community nurses' ability to detect arterial disease by palpation of pedal pulses and to compare these figures with the recording of a resting pressure index. A total of 462 patients (553 limbs) were studied; 167 (31%) had no detectable pulses at the ankle. Of the 93 limbs with a reduced resting pressure index (< 0.9), 37% had detectable pulses. Of the 440 with a normal resting index (> or = 0.9), 25% had no detectable ankle pulses. A number of risk factors were identified. Palpation of pedal pulses alone by community nurses is a poor prediction of arterial disease and should be accompanied by the recording of a resting pressure index.

Aged↗
PubMed1991

Oxerutins in the prevention of recurrence in chronic venous ulceration: randomized controlled trial.

The value of oxerutins [O-(beta-hydroxyethyl)-rutosides] in the prevention of venous ulcer recurrence was investigated in a double-blind randomized controlled trial of 138 patients with recently healed chronic venous ulcers. Oxerutins in the form of Paroven 500 mg twice daily or identical placebo were given, and all patients were provided with elastic compression stockings. At follow-up 3 months later, patients were assessed for re-ulceration and for tablet and stocking compliance. Oxerutins (n = 69) and placebo (n = 69) groups were well matched for age, sex, duration of previous ulceration and deep vein thrombosis. Cumulative re-ulceration by life-table analysis at 12 and 18 months was 22 and 32 per cent respectively for placebo, and 23 and 34 per cent respectively for oxerutins (P = 0.93). Recurrence was more frequent in patients who complied with both tablets and stockings, suggesting that compliance was influenced by continued symptoms (P = 0.006). This trial failed to demonstrate that oxerutins influenced ulcer recurrence.

Anticoagulants↗
PubMed1990

Effect of premedication on arterial blood gases prior to cardiac surgery.

The effect of premedication on arterial blood gas tensions was studied in thirty adult surgical patients with valvular disease. They were divided into three groups, each group having a different premedication regimen. Blood gas tensions were compared in these patients when awake on the night before surgery, asleep, after premedication and just prior to induction of anaesthesia. Samples were taken while the patient breathed air and each patient acted as his/her own control. The patients were randomised into one of three premedication regimens: 1. intramuscular lorazepam, 2. intramuscular morphine and hyoscine (scopolamine) and 3. oral lorazepam plus intramuscular morphine and hyoscine. There was a statistically significant though not clinically significant rise in PaCO2 and fall in pH following premedication with lorazepam, morphine and hyoscine. There was also a significant fall in PaO2 associated with morphine and hyoscine premedication which was greater than that which occurred with unsedated sleep. Patients who are to undergo cardiac valvular surgery should receive supplementary oxygen following premedication and during transfer to the operating room.

Administration, Oral↗
PubMedDate not supplied

Community leg ulcer clinics: cost-effectiveness.

This study investigates the cost-effectiveness and efficacy of a new service provided by community leg ulcer clinics, and compares it with treatment in existing hospital-based venous ulcer care clinics. Data were provided prospectively from district nurses and retrospectively from patients. Success in treatment was assessed as a percentage of ulcers completely healed after 12 weeks of treatment, analysed by the up-table method. Treatment success of 22% at 12 weeks using existing methods compared with 80% in community clinics. Costs were estimated to be 433,600 pounds and 169,000 pounds respectively. These findings indicate that community leg ulcer clinics were more effective and less expensive than the previous system of care.

Aged↗
PubMedDate not supplied

Know how. Four-layer bandaging.

The concept of four-layer bandaging originated in the 1980s at Charing Cross Hospital, London. Since then, a second four-layer system in kit form has been developed. The results of a recent trial involving 232 patients showed that the two systems have equivalent healing. Today, four-layer bandaging is a popular compression regime, and is used in a wide range of health-care settings. Ease of application of the bandages, and reproducibility, mean that it is not only a therapeutic technique but a very safe one.

Bandages↗