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Biomedical subjects

K T Kirchhoff

Publications and source records attributed to K T Kirchhoff.

At least 55 records · Page 3Linked to original sources
PubMed1981

A strategy for surveying nursing practice in institutional settings.

Two major obstacles encountered when surveying nursing practice in institutional settings are obtaining a representative sample and collecting an adequate number of observations at a reasonable cost. Past efforts to deal with these problems are reviewed briefly, and results are reported from a two-stage mail survey of a national sample of critical-care nurses. The first stage involved attempts to procure a list of staff nurses from head nurses of critical-care units at 240 randomly selected institutions. An 86% response rate was obtained. The second stage involved mailing questionnaires to a random sample of 600 critical-care nurses listed. Completed, mailed questionnaires were obtained from 87%. Little evidence of bias due to administrative selection and/or volunteerism was found in the lists of staff nurses. An analysis of membership in professional nursing organizations indicates that more than one half of the nurses who responded to this survey would not have been included had the sample been selected from organizational membership lists.

Data Collection↗
PubMedDate not supplied

Decontamination of vinyl urinary drainage bags with bleach.

The purpose of the study described here was to investigate whether vinyl urinary leg and bed bags used for a 4-week period in the acute rehabilitation setting could be safely reused after having been decontaminated daily with a diluted bleach rinse. Rehabilitation patients who had bladder dysfunction and used vinyl urinary drainage bags (N = 88) were randomly assigned to control (C) and experimental (E) groups; 54 patients completed the study. Group C's bags were replaced weekly; group E's were replaced after 4 weeks. The bags of patients in both groups were decontaminated in identical fashion each day. On the patient's admission to the study, a baseline assessment was completed, a urine culture was obtained, and sterile drainage equipment was provided. Each week for 4 weeks, urine and bag characteristics and signs and symptoms of urinary tract infection were noted. No statistically significant differences (p < .5) were found between the groups. There were no clinical signs of infection requiring treatment, no changes in bag appearance or integrity, and no infection outbreaks associated with a single urinary tract pathogen that would indicate cross-contamination.

Colony Count, Microbial↗
PubMedDate not supplied

Using the journal club as a component of the research utilization process.

Although journal clubs are recommended for research utilization, the various ways in which journal clubs are conducted do not always lead to research utilization. Major institutional changes in practice must be preceded by a comprehensive literature search and a complete review. An example is provided of how a series of journal clubs using the comprehensive search approach led to research utilization.

Clinical Nursing Research↗
PubMedDate not supplied

Roles and responsibilities of clinical nurse researchers.

A follow-up survey of 142 nurse researchers employed in clinical settings (NRECS) was conducted 10 years after the first one conducted by Knafl, Bevis, and Kirchhoff in which only 34 individuals qualified for inclusion. An 80-item questionnaire included items about the structure of the position, processes used, variables that may influence outcomes, and outside activities. When ineligible persons were excluded, the response rate was 75 per cent. Most commonly NRECS had positions in clinical settings only (55.7 per cent), offices (75.5 per cent), some staff (72.6 per cent), and secretarial support (52.8 per cent), and they usually reported to the chief nurse executives (71.7 per cent). Although the majority of NRECS reported responsibility for research activities, the average time spent on research is only 50 per cent. Most (82 per cent) have a nursing research committee, but NRECS also sit on other research-related committees in the department or hospital. Details about salary, responsibilities, and processes will be helpful to those preparing themselves or others for this role, for those who wish to start such a position for themselves or another, or for those in the role wanting to know how other NRECS perform.

Clinical Nursing Research↗
PubMedDate not supplied

Comparing two methods of topical anesthesia used before intravenous cannulation in pediatric patients.

INTRODUCTION: The purpose of this study was to compare the efficacy of two methods of topical anesthesia before venipuncture or intravenous cannulation of pediatric patients to assess which type of topical anesthetic would better alleviate pain in the least amount of time with the greatest success rate of cannulation. METHODS: This study was a randomly controlled trial of 100 preoperative pediatric patients aged 5 to 21 years. The following methods of topical anesthesia were compared: (a) iontophoresis of a topical solution of 2% lidocaine with epinephrine 1:100,000 using a Phoresor Dose Controller (PDC) with Numby Stuff electrodes and a eutectic mixture of local anesthetic and (b) 2.5% lidocaine and 2.5% prilocaine (eutectic mixture of local anesthetics [EMLA] cream). RESULTS: Children reported less pain with iontophoresis (M = 0.08) compared with EMLA cream (M = 1.88, P < .001). Time to accomplish topical anesthesia was shorter with iontophoresis (13 minutes) compared with EMLA cream (60 minutes, P < .001). Failure to accomplish venipuncture occurred 5 times with the iontophoresis method and 8 times with the EMLA method (not significant). No dermal burns resulted from use of iontophoresis. DISCUSSION: We conclude that use of iontophoresis in pediatric patients is safe, rapid, and significantly more effective than is EMLA cream in reducing pain associated with venipuncture or intravenous cannulation.

Administration, Topical↗
PubMedDate not supplied

Altering children's distress behavior during orthopedic cast removal.

The hypothesis treated was that discrepancy between expected and experienced physical sensations (what is felt, seen, heard, tasted, and smelled) during a threatening experience will result in distress. The subjects were 84 children, 6 to 11 years of age, male and female. The threatening experience was orthopedic cast removal. Tape recorded preparatory information was used to vary systematically expectations about physical sensations. The children were randomly assigned to one of three information groups: 1) sensory information which described the sensory experience during cast removal, 2) procedure information which described the steps of the experience, 3) control group which heard no tape recorded information. Nonverbal and verbal signs of distress reactions and the pulse rate were observed during cast removal. Signs of distress were scaled from zero to two, with zero meaning no distress behaviors and two, high distress behavior. A two-factor analysis of variance (two levels of pre-fear and three levels of information) was used for analysis. As hypothesized, the mean distress score for the sensation group (.50) differed significantly from the control group mean (1.00 p less than .025). The procedure group distress score mean (.71) fell between the sensation and control group means but did not differ significantly from the control group mean. The no pre-fear group distress score mean (.52) was significantly lower than the some pre-fear group mean (1.00 p less than .02). Mean pulse rate changes for information groups for before to during cast removal were in the same order as the distress scores, but the differences were not statistically significant. The findings were similar to those from other tests of the hypothesis.

Adaptation, Psychological↗
PubMedDate not supplied

An approach to publishing an edited book.

This article outlines the steps taken by the authors to publish a co-edited nursing research book to assist nurses interested in editing a book or writing a book chapter. The authors' experiences are used to help illustrate the preparation and editing of manuscripts. Collaboration among co-editors, chapter authors (contributors), and the staff of the publishing company is vital when publishing an edited book.

Books↗
PubMedDate not supplied

Infant-feeding practices. Mothers' decision making.

Fifty-one primarily low-income, single, black mothers completed a questionnaire. More than one-half of the sample population reported that decisions about infant feeding were made by the end of the first trimester. Almost one-third of the mothers decided to breastfeed. Of that group, one-half supplemented breastfeeding with formula. More than one-half of the sample reported that external factors influenced their final decisions about infant feeding. More than one-half of the sample population reported that a nurse never discussed infant feeding with them. The role of nursing in infant-feeding decisions and patient teaching needs to be reevaluated.

Adult↗
PubMedDate not supplied

Metabolic bone disease in very-low-birth-weight infants: assessment, prevention, and treatment by neonatal nurse practitioners.

OBJECTIVE: To describe the current practice of neonatal nurse practitioners in assessing skeletal health and preventing and treating metabolic bone disease in very-low-birth-weight infants. DESIGN: Descriptive, retrospective survey. PARTICIPANTS: Neonatal nurse practitioners in the continental United States were systematically randomly selected. A 64% response rate was obtained (112). MAIN OUTCOME MEASURES: Responses to questions about assessing skeletal health and preventing and treating metabolic bone disease in very-low-birth-weight infants. RESULTS: Current practice of neonatal nurse practitioners includes assessing skeletal health of very-low-birth-weight infants on the 7th (47.3%) or 14th (19.6%) day of life, with subsequent assessments every 7 (63.3%) or 14 (18.8%) days. Neonatal nurse practitioners (85.1%) estimate the incidence of metabolic bone disease at less than 15%. Neonatal nurse practitioners initiate total parenteral nutrition (99%), provide parenteral calcium and phosphorous in ratios of 1.3-1.7:1 (9%), and add powdered fortifier (90.1%) and liquid fortifier (25.2%) to expressed breast milk. All respondents use formulas made for premature infants. Physical therapy is used by 46.8% of neonatal nurse practitioners. CONCLUSIONS: Neonatal nurse practitioners underestimate the incidence of metabolic bone disease. Parenteral calcium and phosphorous are given but in quantities that differ from the recommended ratio. Most neonatal nurse practitioners use formulas made for premature infants and add powdered fortifier to expressed breast milk. Although physical therapy is prescribed, more research on its effect on bone mineralization is warranted before this practice is recommended without reservation.

Bone Diseases, Metabolic↗