Biomedical subjects
P J Hawthorn
Publications and source records attributed to P J Hawthorn.
Postoperative temperature and infection in patients undergoing general surgery.
During a study concerned with postoperative hypothermia, Closs (1985) noted an association between patients' core temperatures in the immediate postoperative period and respiratory infection. In this paper, a small follow-up study is reported in which the relationship between postoperative temperature and the development of infection (respiratory, wound or urinary tract) was investigated in 41 patients who underwent general surgery. Aural and oral core temperatures were monitored at 270, 300 and 330 minutes following return to the ward postoperatively. In the week following surgery, patients were monitored daily for any sign or symptom of infection. Reference was made to the patient, nursing notes, medical notes and physiotherapist (when available). Seven of the 16 patients (44%) exhibiting an aural core temperature of greater than or equal to 37.8 degrees C between 270 and 330 minutes post-return to ward developed infection while five of the 25 patients (20%) exhibiting an aural core temperature of less than 37.8 degrees C developed infection. Oral temperature measurements (using ward mercury-in-glass thermometers) showed a very similar pattern. Overall, infection was detected in 12 of the 41 patients (29%) in the 6 days following surgery, 11 having a respiratory infection and one a wound infection.
Lip function and eating after a stroke: a nursing perspective.
The social and psychological effects of eating and drinking difficulties are often overlooked. The collection of food around the lips during meals is an example of a little discussed but embarrassing and unsightly problem commonly experienced after a stroke. In a group of 20 stroke patients, the incidence of this problem was significantly higher than that found in a group of medical patients of similar age and sex (P less than 0.001). It was a cause of some distress to patients. Analysis of the care given to this group of patients at mealtimes would suggest that there is scope for nurses to contribute more to the rehabilitation of patients' lip function after stroke. The efficacy of therapy has yet to be evaluated.
The needs of relatives of patients admitted to the coronary care unit.
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The prevalence of pressure sores within an area health authority.
A point prevalence survey carried out to determine the number of pressure sores within the Nottingham Health Authority revealed that 5.3% patients were affected (132 patients out of 2513). The majority of patients were elderly (80.3% aged over 65), female (76.5%), and either categorized as immobile or having very limited mobility (77.2%). There were 233 pressure sores, 54.9% of which were on the buttocks or sacrum, and 24.9% of which were on or near the heels and ankles. Nine different cleansing agents were in use, 31 different preparations were applied to the sores and nine types of dressings were employed, with little standardization of use. The most popular aids used for the relief of pressure areas included synthetic sheepskin pads (supplied to 46.2% of the affected patients) and ripple mattresses (supplied to 28.8% of the affected patients). The prevalence of pressure sores within the health authority is indicated. These findings are similar to those of a previous study and may be applicable to other health areas.
Factors affecting perioperative body temperature.
Factors affecting body temperature in the perioperative period were investigated in two groups of surgical patients (cholecystectomy and repair of fractured femur). Core, toe skin and thigh skin temperatures were assessed pre and postoperatively for all subjects. A control group showed a significant fall in toe skin temperature only during exposure to theatre conditions, whereas all of the surgical patients underwent falls in core temperature. The fractured femur patients sustained significantly greater reductions in core temperature than the cholecystectomy patients. Age and ambient theatre temperature were found to be the most influential factors affecting this fall in core temperature. Body composition had less of an influence than these two variables, but it was found that the patients with the greatest body fat contents had the smallest reductions in core temperature. Seven of the 31 patients returned to the ward with core temperatures below 35 degrees C, and only one of these seven received assistance in rewarming. Four of the 31 patients developed significantly higher core temperatures than the remaining 27 during the immediate postoperative period, and these four subsequently developed respiratory tract infections. Standard monitoring of temperature on the wards during the immediate postoperative period failed to identify postoperative hypothermia or pyrexia in the majority of cases.
Measuring change in nursing practice.
This report gives an account of the development of a method to measure the effects of changes in nursing practice for a group of patients. Staff and nurses on a 20-bed female geriatric ward were observed for a 3-day period before the 'nursing process' was gradually introduced. Two years later a second 3-day period of observation took place. Methodology is discussed in some detail and the results are presented.
Supervision of dissertations of undergraduate nursing students.
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Principles of research: a checklist.
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