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Biomedical subjects

E B Rudy

Publications and source records attributed to E B Rudy.

53 records · Page 3Linked to original sources
PubMedDate not supplied

Faculty practice: creating a new culture.

This article provides specifics on the development of a clinical track for faculty appointments at the University of Pittsburgh. The criteria to be used for appointment and promotion on the clinical track are discussed along with the practice requirements of 60 hours per term of participation in and responsibility for direct care of patients. The purposes of faculty practice are set forth along with the formation and functioning of a Faculty Practice Council which handles decisions related to faculty practice. Results of the first year after implementation of a clinical track showed that 64 per cent (18) of the faculty had met all of their faculty practice obligations; of the remaining 36 percent (10) who had not, a variety of circumstances were cited. The Income to the School of Nursing for faculty practice, although modest, has helped to highlight that practice is valued and an integral part of the faculty role.

Nursing Faculty Practice↗
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Body-fat measurements and athletic menstrual irregularity.

The purpose of this study was to compare four measurements used as estimates of body fat that have been used in previous studies to determine whether the association between body fat and athletic menstrual irregularity (AMI) is measurement dependent. In a sample of 112 marathon runners, 94 responded to questions regarding their menstrual cycle. Of these, 30 (32%) reported irregular or absent menses, and 64 (68%) reported regular menses. Of the 30 subjects reporting menstrual irregularities or amenorrhea, 13 (43%) reported having had menstrual irregularity or amenorrhea prior to taking up running. Estimates of body fat were based on Mellits and Cheek's (1970) equation for estimating percentage of body water, Lutter and Cushman's (1982) height and weight categories, actual gross body weight, and weight loss of 10 lb (4.5 kg) or more since taking up the sport. In this sample of marathon runners, none of the four methods used to estimate body fat supported a relationship between menstrual irregularity and low body fat. A significant (p less than .001) relationship was found between prior menstrual irregularity and the development of AMI after starting to run.

Adipose Tissue↗
PubMedDate not supplied

Nutrient intake of women runners and nonrunners.

The nutrient intakes of women who ran at different levels of intensity and the relationship between nutrient intake and ovulatory disturbances were studied. Ninety-five women, including sedentary non-runners (n = 16), low-level runners (n = 27), medium-level runners (n = 29), and high-level runners (n = 23), completed data for a 3-day nutritional assessment. The high-level runners met the Food and Nutrition Board's Recommended Daily Allowances (RDAs) for all 17 nutrients examined, with the exception of calcium. The other groups of women failed to meet RDAs for iron, carbohydrate, and fiber. In general, the women in the study reported healthier diets than did women in a general national survey of nutrient intake conducted in 1985. Eighty-two of the women reported luteinizing hormone level data that were accurate enough to indicate ovulatory functioning; of these women, 30 had ovulatory disturbances. There was no relationship between ovulatory disturbance and nutrient intake; however, 5 amenorrheic women reported a significantly lower nutrient density intake of fat and higher intake of carbohydrate, fiber, and vitamin A than did the nonamenorrheic women.

Anovulation↗
PubMedDate not supplied

Survival experience of chronically critically ill patients.

Intensive care unit (ICU) patients were randomly assigned to either a traditional ICU or a special care unit (SCU) for chronically critically ill patients. The SCU used a low-technology, family-oriented environment, nursing case management, no physician house staff, and a shared governance model. In comparison, the ICU used high technology, limited family visiting, primary care nursing, and a bureaucratic management model. The survival experience of chronically critically ill patients in the two environments during hospitalization, as well as after hospital discharge, was examined. Using survival analytic techniques, the 1-year cumulative mortality for all patients in the study was found to be 59.9%. Risk of death was significantly lower after discharge than during hospitalization. Similar mortality experiences were found for SCU and ICU patients. Thus, the high-technology ICU environment did not produce better outcomes than the SCU environment.

Aged↗
PubMedDate not supplied

Effect of short-duration hyperventilation during endotracheal suctioning on intracranial pressure in severe head-injured adults.

A repeated measures randomized within-group design was used to determine the effectiveness of controlled short-duration hyperventilation (HV) in blunting the increase of intracranial pressure (ICP) during endotracheal suctioning (ETS). A multimodal continuous real-time computerized data acquisition procedure was used to compare the effects of two HV ETS protocols on ICP, arterial pressure, cerebral perfusion pressure (CPP), heart rate, and arterial oxygen saturation in severe head-injured adult patients. The results indicated that short-duration HV for 1 minute, which decreases the PaCO2, reduced ETS-induced elevations in ICP while maintaining CPP. However, it is not clear whether short-duration HV is neuroprotective, particularly in ischemic regions of the brain. Therefore, before a change in practice is implemented on the use of short-duration HV as a prophylactic treatment against ETS-induced elevations in ICP, additional questions on cerebral oxygen delivery and uptake need to be answered.

Adolescent↗
PubMedDate not supplied

Auditing research studies.

BACKGROUND: Recognizing the increasing attention being given to reports of misconduct, fraud, and unethical behavior in biomedical research, it appears timely for nurse researchers to engage in an organized method of peer review. OBJECTIVES: To describe an auditing process for funded research grants, the guidelines used to conduct the research audit, and the results to date. METHODS: The audit encompassed National Institutes of Health (NIH)-funded projects and their respective research teams, 12 faculty auditors using an audit worksheet developed by the Center for Nursing Research. RESULTS: Overall, auditing of research grants was viewed positively by both investigators and faculty auditors. Minor problems were identified that could be corrected. Only one grant required a second review. CONCLUSIONS: Specific guidelines are proposed for future audits that include level of funding and timing of audits.

Financing, Organized↗
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Staffing and pattern of mechanical restraint use across a multiple hospital system.

BACKGROUND: In an effort to enhance patient safety in acute care settings, governmental and regulatory agencies have established initiatives aimed at limiting the use of mechanical restraints. Concurrently, hospital staffing levels are undergoing changes raising concerns about the impact these changes may have on restraint use. No studies to date have described the impact these two initiatives have had on restraint use in acute care hospitals. OBJECTIVES: To determine across a multiple hospital system: (a) the rates, frequencies, duration, and timing of restraint use, and (b) the relationship between restraint use and staffing. METHODS: This was a secondary analysis of prospective, observational data from a large outcomes database for 10 acute care hospitals. Monthly data were obtained from 94 patient care units for periods ranging from 1-12 months for a total of 566 cumulative months during 1999. RESULTS: The system restraint application duration rate (total restraint hours/total possible hours) was 2.8% (hospital ranges: 0.3-4.4%). More restraints were applied on night shifts (48.8%; n = 5,296) than on day (33.5%; n = 3,634) or evening shifts (17.7%; n = 1,926) (p < .0001) and most applied at midnight (31.7%; n = 3,441) followed by 0600-0900 (33.3%; n = 3,614). There was a weak positive relationship between staffing and restraint use (r = 0.276, p = .0001) at the system level and units with higher staffing levels also had higher baseline restraint use (p < .0001). CONCLUSIONS: Restraint frequency, duration, and timing may have been altered by recent initiatives, and there is beginning evidence that differences exist between community, rural, and tertiary hospitals. While there is a weak positive relationship between higher staffing and restraint use at the system and unit level, further exploration of the influence of other factors, specifically patient acuity, are in order. The finding of unit variability and consistent restraint application times provides a starting point for further quality initiatives or research interventions aimed at restraint reduction.

Humans↗
PubMedDate not supplied

Intensity of jogging. Relationship with menstrual/reproductive variables.

The relationship between intensity of jogging and various menstrual/reproductive factors in women were investigated. Data were collected by questionnaire from 319 women who participated in a running event that included both a 6.2-mile (10 K) run and a 26.2-mile marathon in northeastern Ohio. Findings reaffirmed the notion that scant menstrual flow, skipped menses, and menstrual irregularity are significantly related to the intensity of jogging; age at menarche, infertility, and uterine prolapse were not. Thirty-two percent of the women felt that jogging decreased their menstrual discomfort, and 44% reported better jogging performance right after or between menstrual periods.

Abortion, Spontaneous↗
PubMedDate not supplied

Professional and lay interrater reliability of urinary luteinizing hormone surges measured by OvuQuick test.

OBJECTIVE: To determine the reliability of women, unmotivated by fertility problems, to accurately assess and record the urinary luteinizing hormone surge indicated by color changes on OvuQuick test pads. DESIGN: A descriptive, correlational study testing the reliability and validity of an instrument. SETTING: The participants' homes. PARTICIPANTS: 114 college-educated, white women. INTERVENTIONS: An OvuQuick Test Kit and a Menstrual Cycle Diary were mailed to each participant. The monthly diary and test pads of the participants were reassessed by a master's-prepared nurse. MAIN OUTCOME MEASURES: Women without medical or health-care training are reliable in judging the color changes on the OvuQuick test pads and recording these results in a menstrual diary. RESULTS: Investigator and subject assessment and recording of luteinizing hormone surge results agreed 95% (284 of 300 instances) of the time. In addition, the validity of the luteinizing hormone surge for predicting ovulation was accurate in 93% (26 of 28 instances) of the cases. CONCLUSION: OvuQuick is a reliable and valid test for home evaluation of luteinizing hormone surge and prediction of ovulation.

Adult↗
PubMedDate not supplied

Practice patterns related to mechanical restraint use across a multi-institutional health care system.

In recent years, regulatory and governmental initiatives have focused increased scrutiny on the use and practices associated with mechanical restraints. Consequently, hospitals are increasingly measuring and comparing both internally and externally their restraint practices as they strive to optimize their use and assure the safe care of patients being restrained. This study analyzes 12,860 restraint episodes from 10 acute care hospitals in a single health care system. Overall findings support many previously identified trends related to the types of restraints used and reasons for application. However, findings from this study also suggest that there are differences among rural, community, and tertiary hospitals. This study also provides the first widespread documentation of rates and types of alternative methods attempted and common patient care practices carried out during restraint application. These results can serve as external comparisons for other acute care settings as they strive to minimize and assure safety in restraint application.

Hospitals, Community↗
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A nurse-managed special care unit.

The authors describe the first year of operation of a nurse-managed intensive care unit (ICU). Concerned with the problems, costs, and inadequacies of caring for long-term patients in traditional ICUs, nurse administrators designed a special care unit that incorporates a physical design facilitating family involvement and rehabilitative care, registered nurse case management, and a shared governance management philosophy. Compared with traditional ICUs, the effectiveness of the special care unit is tested in terms of patient and nurse outcomes. Implications of this innovation for health-care delivery systems and the nursing profession are discussed.

Aged↗
PubMedDate not supplied

Patients' and spouses' causal explanations of a myocardial infarction.

This study examined lay explanations of an illness episode, myocardial infarction, at acute and convalescent phases of illness. Data were collected by interviews, using a structured questionnaire during the acute phase of illness (in hospital) and convalescent phase (at home) after discharge, from 50 first-time MI patients and 50 spouses or significant others. Tension (at work, in the home situation, and in general) was the most frequent cause given for the heart attack by both patients and spouses at both phases. Half the patients and half the spouses changed their mind regarding the cause of the heart attack between the acute and the convalescent phases. Further, over 50 percent of the patient/spouse pairs disagreed regarding the cause of illness at both phases. A high percentage of patients changed their smoking, diet, and exercise behavior, even when they did not list these factors as causes of the heart attack. Findings also suggested spouses should be included in discharge planning and special problems which spouses may face after patients' discharge should be addressed.

Adult↗
PubMedDate not supplied

Patient outcomes for the chronically critically ill: special care unit versus intensive care unit.

The purpose of this study was to compare the effects of a low-technology environment of care and a nurse case management case delivery system (special care unit, SCU) with the traditional high-technology environment (ICU) and primary nursing care delivery system on the patient outcomes of length of stay, mortality, readmission, complications, satisfaction, and cost. A sample of 220 chronically critically ill patients were randomly assigned to either the SCU (n = 145) or the ICU (n = 75). Few significant differences were found between the two groups in length of stay, mortality, or complications. However, the findings showed significant cost savings in the SCU group in the charges accrued during the study period and in the charges and costs to produce a survivor. The average total cost of delivering care was $5,000 less per patient in the SCU than in the traditional ICU. In addition, the cost to produce a survivor was $19,000 less in the SCU. Results from this 4-year clinical trial demonstrate that nurse case managers in a SCU setting can produce patient outcomes equal to or better than those in the traditional ICU care environment for long-term critically ill patients.

Adolescent↗
PubMedDate not supplied

Menstrual response to running: nursing implications.

Overt (length of menstrual cycle, duration of menses, and amount of menses) and covert (luteal surge indicative of ovulation and length of luteal phase) menstrual cycle characteristics were studied in a sample of 146 women who participated in four levels of running intensity. Menstrual and running data were collected for 4 months or 3 cycles. There was a significant difference among the four groups in duration of menses and in the amount of menses, with nonrunners having significantly more days of menses and larger amounts of menses than the two highest intensity running groups. However, when a history of skipping menstrual periods between menarche and age 18 was controlled, the differences between the groups were not significant. There were no significant differences among the four groups in incidence of luteal surge or length of luteal phase. When runners were compared to nonrunners, runners reported, on average, a shorter luteal phase than nonrunners. This difference remained when controlling for age and history of skipping menstrual periods. There was no significant difference between the four groups on incidence of ovulatory disturbances (anovulation or more than one cycle with a shortened luteal phase). But, when compared to nonrunners, runners were found to have significantly more ovulatory disturbances. The best predictors of the variance in menstrual cycle characteristics were history of skipping periods between menarche and age 18, and running versus nonrunning.

Adipose Tissue↗