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Biomedical subjects

Melissa Wilson

Publications and source records attributed to Melissa Wilson.

5 recordsLinked to original sources
PubMed2003

Ultrasound assessment of bladder volume: is it valid after delivery?

AIM: To assess the validity of a commercially available bladder volume scanner in the puerperium. METHODS: A prospective blinded comparison of bladder volume measurement after vaginal delivery using the BladderScan bladder volume instrument (BVI) 3000 and Foley catheter; comparison using the intraclass correlation coefficient. RESULTS: The mean difference between the two measurements was a 130-mL over-measurement by the bladder scanner (range: -156 mL to +422 mL). The intraclass correlation coefficient was 0.23 (95% confidence interval 0.00, 0.59). CONCLUSIONS: The BladderScan BVI 3000 is not an accurate instrument to assess bladder volume the day after vaginal delivery. Some of the discrepancy might relate to use of the Foley catheter as the reference standard. Further comparison between the BladderScan and a short female catheter or real time ultrasound is indicated.

Adult↗
PubMedDate not supplied

Implementing evidence-based practice findings to decrease postoperative sternal wound infections following open heart surgery.

Sternal wound infections following open heart surgery are an infrequent occurrence but can have significant impact on patient morbidity, length of stay, and cost of care. The objective of this project initiative was to decrease the incidence of sternal wound infections by examining and changing current practice in the preoperative and postoperative management of patients undergoing open heart surgery. Following a literature review of interdisciplinary best practices, process teams were formed to evaluate our own patient cohort with documented infection. Five key areas were addressed: (1) preoperative skin preparation, (2) antibiotic prophylaxis, (3) blood glucose control, (4) wound care management, and (5) hand hygiene. A retrospective chart review of patients with documented sternal wound infections status post-mediastinal open heart surgery revealed that the average postoperative glucose was 201 mg/dL. An inquiry of practice variations determined the absence of a common provider and causative organism. A change model guided project initiatives and sustainability of new behaviors and practice. Each element of the project initiative had defined outcome measures. Staff nurses participated in peer education and outcome data collection. Following the implementation of evidence based practice changes, a linear decrease in sternal wound infections was documented. Nurses play a critical role in identifying, orchestrating, and evaluating change efforts in clinical practice. Outcomes are enhanced when nurses collaborate with all stakeholders in the practice improvement initiative.

Antibiotic Prophylaxis↗