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Biomedical subjects

P E Windle

Publications and source records attributed to P E Windle.

10 recordsLinked to original sources

The effects of acupressure on the incidence of postoperative nausea and vomiting in postsurgical patients.

Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications. Aside from pharmacological interventions, other complementary healing modalities have been introduced to assist patients in decreasing PONV and improving postoperative outcomes. This study examined acupressure as a potentially holistic and safe complement to the more traditional approach of using drugs to prevent and/or relieve nausea and vomiting in the postoperative patient. Acupressure involves constant pressure (without puncture of the skin) on the Nei Guan acupuncture points through the use of a British product called Sea-Bands (Sea Band UK Ltd, Leics, England). These bands are made of elasticated fabric, with a small round plastic button inside. A quasi-experimental research design was used to examine the effects of unilateral and bilateral application of acupressure on 157 patients who are prone to PONV: postgynecological, postplastic, and posturological surgery patients. The incidence of PONV was determined through retrospective chart reviews. The hypothesis was that there would be a difference in the incidence of PONV between 5 groups: group 1 (Sea-Bands with acupressure on both wrists), group 2 (Sea-Bands with acupressure on one wrist), group 3 (wristband without acupressure on both wrists), group 4 (wristband without acupressure on one wrist), and group 5 (no wristband). This hypothesis was examined by using a one-way analysis of variance (ANOVA); it was not supported. Neither unilateral nor bilateral application of acupressure significantly affected the incidence of nausea and vomiting. These findings must be viewed with caution, however, because power analysis showed low effect sizes and an inadequate sample size. Further research is recommended with a larger sample size. This study has made perianesthesia nurses more aware of other complementary modalities to assist patients with nausea and vomiting.

Acupressure↗

COMIT: improving patient outcomes.

The Continuous Outcomes Measurement Improvement Technique (COMIT) model of problem-solving focuses on the reduction of a variance or the improvement of a patient outcome. A specific variance, pain tolerance, is used to reflect application of the model. The steps are explained as the model is applied to a variance resulting in an improved patient outcome.

Humans↗

A perioperative acuity measurement system.

An integrative acuity measurement system has been developed to increase efficiency and effectiveness of care delivery. Patients are classified into groups on the basis of nursing care required, thus facilitating both determination of actual nursing cost and accurate projection of staffing needs. It provides a universal language among perioperative departments for measuring similar outcomes.

Data Collection↗

Critical pathways: an integrated documentation tool.

A multipurpose six-page, three-fold flow sheet improves patient outcomes, meets JCAHO standards and facilitates easy tracking of a patient's progress. The flow sheet is divided into nursing process, expected patient outcomes, critical pathway and variance report. Outcomes management is an effective process to control costs and improve patient outcomes.

Documentation↗

A COMIT model utilization to improve first-case start time.

The purpose of this article is to review the problems and processes impacting the deviation in first-case actual start times when compared to first-case scheduled start times. This article will also discuss the Continuous Outcomes Measurement and Improvement Technique (COMIT) model for problem resolution and share the experiences encountered by a group of collaborative nurse manager leaders in their outcome improvement efforts. The overall process improvements are discussed using the eight-step COMIT model, which showed the overall success of the project.

Analysis of Variance↗

The professional salary model: meeting the bottom lines.

The challenge for two units of St. Luke's Episcopal Hospital in Houston, Texas was to achieve quality and financial viability while maintaining staff satisfaction. The situation imposed by the current health care climate, with its emphasis on reducing costs while maintaining quality and productivity, mandated a change in the compensation structure. The Professional Salary Model was piloted on two units and refined along the way to ensure that the model, as practiced, met the staff's needs. Evaluation of the program revealed that the goals of quality, productivity, financial viability, and staff satisfaction were achieved.

Cost Control↗

Benchmarking for unrelieved pain in a postanesthesia care unit.

The problem of unrelieved pain in the PostAnesthesia Care Unit (PACU) is an outcomes management concern. This article discusses the steps taken by the PACU staff to establish a benchmark for unrelieved pain and to evaluate the effect of the Multidisciplinary Pain Management Initiative (MPMI) action plan on the outcomes of length of stay and cost.

Critical Pathways↗