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Biomedical subjects

J Paice

Publications and source records attributed to J Paice.

10 recordsLinked to original sources
PubMed2001

The effect of standard care, ibuprofen, and music on pain relief and patient satisfaction in adults with musculoskeletal trauma.

OBJECTIVE: The purposes of this study were to determine the most effective nursing intervention to decrease pain for patients with minor musculoskeletal trauma and moderate pain at triage and to examine patient satisfaction. METHODS: Patients were assigned to 1 of 3 intervention groups: (1) standard care (ice, elevation, and immobilization); (2) standard care and ibuprofen; or (3) standard care and music distraction. Patients were monitored for pain ratings for 60 minutes. Patients who sustained minor musculoskeletal trauma within the past 24 hours and presented with pain ratings of 4 or greater were included. Two patient satisfaction questions were asked upon discharge from the emergency department. RESULTS: Seventy-seven patients met the inclusion criteria. No differences in pain ratings between groups were demonstrated. A statistically significant reduction in pain for all patients occurred at 30 minutes (F = 16.18, P <.01) and was maintained at 60 minutes. However, 70% of patients continued to report pain ratings of 4 or greater (on a scale of 1 to 10) at 60 minutes. The reduction in pain was not found to be clinically significant.Eighty-four percent of patients stated that they were more satisfied with their overall care in the emergency department because of the immediate attention to pain relief they received at triage. No differences in satisfaction existed between treatment groups, although patients who reported higher pain ratings expressed statistically significant lower satisfaction with pain management scores (F = 9.375, P =.003). CONCLUSION: None of the therapies-standard care (ice, elevation, immobilization), standard care with ibuprofen, or standard care with music distraction-provided clinically significant pain relief to patients who had minor musculoskeletal trauma (ie, sprains and fractures) and moderate pain at triage. Interestingly, satisfaction scores were sometimes positive, even when pain was not relieved.

Adult↗
PubMed1999

Preoperative PCA teaching program to manage postoperative pain.

Patient-controlled analgesia (PCA) therapy was designed to provide patients with greater control in managing their pain. However, many patients continue to suffer from moderate to severe pain due to lack of knowledge about how to use PCA therapy. The results of this quasi-experimental study demonstrated that patients who received structured preoperative teaching had statistically significant higher knowledge regarding the use of PCA therapy and more positive attitudes toward using pain medicine. Patients who received the video teaching reported better pain control and satisfaction with pain management 4 and 8 hours following their surgical procedures.

Adult↗
PubMed1999

Meperidine utilization and compliance with Agency for Health Care Policy and Research guidelines in a tertiary care hospital.

The Agency for Health Care Policy and Research (AHCPR) established guidelines for the use of meperidine (demerol), a common inpatient analgesic. These guidelines define standards of care for acute and chronic cancer pain management and address many of the problems with meperidine and its metabolite, normeperidine. The purpose of this study was to determine whether meperidine was prescribed in compliance with AHCPR guidelines, whether patients exhibited any adverse reactions to meperidine, and to determine the analgesic efficacy of meperidine. Three hundred inpatient charts were reviewed and identified meperidine as the primary analgesic in 157 nonobstetric inpatients. Age, sex, weight, dosing interval, route of administration, duration of meperidine use, serum chemistry values, primary diagnosis, associated medical conditions, and medications concurrently being taken with meperidine were the parameters analyzed. An interview was conducted to ascertain medical and drug history, chronicity of pain syndromes, analgesic drug history, and analgesic efficacy. A visual analog scale for pain (range = 0 to 10) and an analgesic satisfaction survey (range = 1 to 5) were used. Of 157 patients, 124 (79.8%) were in conflict with AHCPR guidelines. The most frequent conflict was found to be suboptimal dosing regimen and treatment of chronic pain. Often concurrent analgesics were given with the meperidine to achieve adequate analgesia. Higher analgesic satisfaction scores were noted when meperidine was given with concurrent analgesics. Meperidine also was administered to patients in renal failure or with medications contraindicated with meperidine use. No significant adverse effects were noted with meperidine use in this sample population other than an increased incidence of confusion in the elderly population.

Academic Medical Centers↗
PubMed1998

A rapid assay of endotoxin in whole blood using autologous neutrophil dependent chemiluminescence.

A rapid (30 min) whole blood assay for the detection of lipopolysaccharide (LPS) is described. This chemiluminescent (CL) assay utilizes the CR1 and CR3 receptor-induced oxidant production of polymorphonuclear leucocytes as a detection platform. The differential priming of neutrophils in whole blood by LPS-antibody complexes allows the specificity of the assay to be achieved. Oxidant released in response to complement opsonized zymosan results in luminol oxidation and subsequent light emission. This is dependent on heat labile putative complement proteins in the plasma. The assay consists of a control which measures baseline whole blood neutrophil oxidant production. The test assay contains murine monoclonal IgM antibody against the Lipid A epitope of LPS and measures the enhanced chemiluminescent response of the neutrophils in the presence of LPS-antibody complexes. Maximal sensitivity of the CL assay is dependent upon optimal antigen-antibody equivalence and duration of pre-incubation with the whole blood sample. The quantification of LPS is possible by inclusion of a positive control containing a maximally reactive LPS dose (800 pg/ml Escherichia coli 055:B5 LPS at an antibody concentration of 0.8 microg/assay). The CL assay is insensitive to variations in patient neutrophil concentration over a minimum range of 0.5 to 20 x 10(9) cells/l. The CL assay is widely reactive with the LPS of many strains of gram negative bacteria but not with the cell wall products of gram positive bacteria or Candida and Aspergillus. In comparison to acid extraction chromogenic LAL, the CL assay demonstrates superior recovery precision and accuracy in in vitro studies. This was reproducible over a wide range of LPS concentrations (0.017-1.6 EU/ml or 20-2000 pg/ml). This assay may be a clinically useful tool for the diagnosis of infection or endotoxin in patients.

Antibodies, Bacterial↗
PubMed1998

Tobacco-related instruction in undergraduate nursing education in Illinois.

Tobacco use is responsible for more deaths in the United States than any other factor. Nurses are in a unique position to convey life-saving messages to clients regarding tobacco use. To gauge the type and extent of tobacco-related background knowledge acquired by nurses in the course of their education, the Nurses' Committee of the Illinois Division of the American Cancer Society (ACS) surveyed 70 nursing programs in the state of Illinois. The number of lecture hours spent on tobacco-related issues was greater in LPN programs than in either associate or baccalaureate degree programs, and instruction was scattered throughout the curriculum of each program. Most schools reported heavy reliance on adult medical-surgical textbooks to convey tobacco-related content. The most recent editions of the textbooks used by the schools were reviewed, and they also were found to adopt a scattered approach, with a disappointing lack of depth regarding the hazards of tobacco. It is recommended a single course be identified as responsible for relaying tobacco-related content and information supplied by general medical-surgical textbooks be supplemented by materials drawn from other sources.

Curriculum↗
PubMed1995

Pain control in hospitalized postsurgical patients.

The purpose of this study was to describe the pain experience of 100 randomly selected postsurgical patients, identify discrepancies between physician, nurse, and patient reports of pain intensity, and characterize the documentation of patients' pain experiences within the hospital record.

Adult↗
PubMed1991

Collaborative research under the unification model.

The research role of the clinical nurse specialist is often the most difficult to implement. At the masters level, efforts are generally directed at utilization and evaluation of research more than design and implementation. Collaboration between several investigators, however, is an efficient and effective method of pooling the resources of a variety of researchers, allowing the actualization of all aspects of the research process. A collaborative effort to look at the clinical problem of fatigue was undertaken by a group of masters-prepared oncology nurses. Strategies for effective collaboration are outlined. Issues related to gaining group commitment and to delineating roles at the onset, voluntary participation, and timely communication are discussed. A realistic timetable and regular informal meetings helped to sustain the momentum of the study. All members were able to contribute a part of the completed project and to experience the professional and personal satisfaction of "owning" a research project from start to finish.

Humans↗
PubMed1986

Topic selection for the Australian census of population and housing.

"We describe how topics were selected for the Australian Census of Population and Housing. Australia has adopted an open assessment of topics submitted by users and the general public and then performed field tests of difficult or sensitive questions. For the 1986 Census, special attention was given to the development of a census question on ethnic origin."

Australia↗