This study was undertaken to determine differences between caloric intake and requirements of critically ill, enterally fed, neurosurgical and neurotrauma patients and to determine the nature and frequency of interruptions in enteral feedings in this same population. This descriptive, prospective study was conducted in a surgical intensive care unit (ICU) in a university teaching hospital. The sample consisted of 52 mechanically ventilated, critically ill patients with a mean age of 48.96 years who were receiving enteral nutrition for at least two days. Basal energy requirements, daily nutritional intake and enteral feeding interruption characteristics were recorded for a total of 586 study days. Underfeeding due to interruptions occurred in the majority of patients for the first eight days following initiation of enteral feeding. Reasons for underfeeding were interruptions of continuous tube feedings due to medication administration via the feeding tube (31%), feeding tube displacement (27%), surgery (12%), ileus (9%), radiologic studies (9%), airway management (8%), bedside procedures (3%) and agitation (1%). The frequency of these enteral feeding interruptions may indicate inadequate nutritional support, highlighting the importance of performing daily nutritional monitoring to prevent malnutrition.

Adolescent↗

PubMed1991

The effect of familiar and unfamiliar voice treatments on intracranial pressure in head-injured patients.

Limited research has been conducted exploring the relationship between verbal stimulation and intracranial pressure (ICP). The purpose of this study was to investigate effects of verbal stimulation on ICP in head-injured patients. The sample consisted of 12 head-injured patients with a mean age of 31.5 years and mean Glasgow Coma Scale score of 7.8. A message was recorded by a familiar voice (family) and an unfamiliar voice (researcher). The familiar voice message was played to each subject. After a rest period, the unfamiliar voice message was played. ICP was recorded before, during and after playing both taped messages. Results demonstrated little change in ICP of head-injured patients when exposed to recorded verbal stimuli. Paired t-tests demonstrated no statistically significant differences between means. Results suggest families of head-injured patients with normal ICP can verbally interact with the patients for short periods without significant increases in ICP.

Adolescent↗

PubMed1991

Implementation of a patient fall prevention program.

Falls among hospitalized patients are common occurrences and can have detrimental effects on patient outcomes. Identifying high-risk patients and taking measures to prevent patient falls have been successful. The purpose of this project was to decrease the fall rate in adult neuroscience patients. This was accomplished through implementation of a patient fall prevention program. Patients were assessed for risk factors associated with patient falls. Risk factors were identified through the use of the patient's history, nursing data base and patient classification system. Patients with identified risk factors were placed on fall precautions which included interventions specifically designed to prevent patient falls. This project resulted in a decrease in the number of patient falls and increased staff awareness of the risk factors associated with falls among adult neuroscience patients.

Accidental Falls↗

PubMed1991

Hyperbaric oxygen therapy: treatment for spinal cord decompression sickness.

Spinal cord injury (SCI) may result from decompression sickness associated with sport and commercial diving. Decompression sickness is caused by the formation of gas bubbles in the vessels and tissues secondary to a reduction in ambient pressure. A complete or incomplete spinal cord injury may result from decompression sickness. Recompression and hyperbaric oxygen therapy is the primary treatment. The use of hyperbaric oxygen therapy (HBO) as a treatment for these injuries can greatly influence the patient's outcome. Early intervention in a recompression chamber may result in complete recovery. If treatment is delayed however, the prognosis for recovery is poor.

Decompression Sickness↗

PubMed1991

The efficacy of six heel pressure reducing devices.

Twenty to 90 percent of pressure ulcers are located on the heel. The purpose of this study was to evaluate the pressure exerted on the heel when the foot in both the supine and the 30 degree elevated position was placed in various heel pressure reducing devices. Interface pressures of six heel devices were measured to determine their performance. Other factors, such as body weight, height shoe size, shoe width, as well as whether the device provided leg support were examined.

Adult↗

PubMed1990

Standardized nursing care plans for acute care SCI: improved documentation.

Adequate documentation of spinal cord injury (SCI) nursing care is necessary for evaluation of patient progress and compliance with standards of care. The objective criteria used to evaluate nursing care include the nursing data base, the care plan, and the nurses' notes. The nursing care plan reflects the needs of the SCI client and is the basis from which documentation about these needs arises. Standards for acute care SCI nursing were recently developed for the 10 designated SCI centers in Florida. To improve the documentation of these standards, neuroscience nurses at Shands Hospital developed standardized care plans that can be individualized for each SCI client. The implementation of these care plans improved documentation of the standards for acute care SCI nursing. Additional benefits included an increased awareness of the nursing diagnoses among staff nurses and improved equality of care for the SCI client.

Documentation↗

PubMed1989