Biomedical subjects
P McMullan
Publications and source records attributed to P McMullan.
The use of chemical restraint in helicopter transport.
INTRODUCTION: Helicopter transport of the combative patient is a major safety hazard facing air medical teams. Although physical restraints alone are helpful, the addition of chemical restraint (CR) often is necessary to control these patients while in flight. METHODS: A survey was conducted to determine the current practices of using nonparalyzing CR in air medical transport programs nationwide. The survey consisted of 24 questions on the use of CR during transport. Each U.S. program belonging to the Association of Air Medical Services was contacted by telephone, and a flight nurse or paramedic provided answers based on personal experience and statistics compiled by his or her individual program. RESULTS: Of the 100 programs responding, benzodiazepines were used most commonly to control agitation with 51% using micazolam. Patients with a head injury required CR more frequently than any other condition (73%). Crews flying larger aircraft reported less need for CR. A physician order was required by only 30% of the programs, but delays infrequently endangered the patient (2%). Only 7% of the responding programs had a patient whose condition deteriorated because of CR. CONCLUSION: CR is necessary in air medical transport. Most programs use short-acting benzodiazepines. Crews in smaller aircraft use CR more frequently, and head injury is the most common condition requiring such restraint.
The impact of computerization on nursing: an interview study of users and facilitators.
When health care settings are computerized, nurses' jobs are affected. Hospitals must understand this important phenomenon in order to develop the best possible implementation strategies that consider the impact nurses may experience. The goals of this study were the following: 1) to explore the personal and job-related effects of computerization on nurses; 2) to determine the factors that helped these nurses cope during the computerization process; and 3) to derive recommendations that could assist hospitals implementing computerization in future. Twenty nurses were identified by their peers as knowledgeable informants for a research interview: 10 staff nurse users and 10 nurse educators or administrators serving as facilitators of the change. The confidential interviews were analyzed using a grounded theory approach with constant comparative analysis of the emerging categories. The investigators developed a visual model showing six themes that have the greatest effect on the nurses: 1) time frame, 2) choice of software, 3) communication, 4) the change process, 5) training, and 6) leadership. These themes were considered within a broad hospital context, in which budget, nurse involvement, policy practice issues, and other concurrent projects also influenced nursing. In addition, personal characteristics of each nurse affected how each nurse experienced the change to computerization. Recommendations from the respondents addressed a wide range of factors that may be useful to other hospitals planning to implement computerization in nursing.
Impact of computerization on nursing: automated order entry, care planning, and implications for recruitment.
Very few empirical studies have been completed which verify the actual benefits of automation for nursing. This article provides an overview of the results and implications of five research studies undertaken at a Canadian Hospital to ascertain the impact of computerization on selected aspects of nursing. These studies found that nurses perceived few positive benefits for direct care givers when order entry, results reporting and care planning were automated. This article will be of particular interest to nurse administrators who are embarking on automation within their hospitals.