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PubMed1998

Marketing innovations to nurses, Part 1: How people adopt innovations.

This article is the first in a two-part series that explores marketing techniques to enhance nurse's adoption of innovations in practice. Introducing new policies and procedures and persuading colleagues to implement them constitute an important part of the WOC nurse role. Nursing research reveals a lag of 8 to 30 years between the time new ideas are generated and nurses use them in practice. This article presents a theoretic grounding based on the Everett Rogers Diffusion of innovation Theory and uses the author's experiences introducing a research-based practice innovation to illustrate concrete and practice-relevant examples of innovation adoption theory and marketing principles in action.

Decision Support Techniques↗
PubMed1998

A shared community-based practice: an alternative model for WOC nursing practice.

In the past, as the populations in many communities have grown, WOC nurses have been hired for each of the major health care facilities located in that community. However health care restructuring has caused many local hospitals to reevaluate their use of specialty practice nurses, including ET/WOC specialists. In response to this trend, a shared community practice model was established that has allowed each agency to make use of ET nursing service on an "as needed" basis, while maintaining daily accessibility to this important resource person. This article describes the evolution and growth of this practice model during the past two decades of intense reform in health care delivery.

Community Health Services↗
PubMed1998

Latex allergy and the WOC nurse: a review of the literature.

The WOC nurse is familiar with products used to manage skin care. Latex sensitivity and allergy is becoming epidemic in the United States and is being studied by the Centers for Disease Control and Prevention (CDC) because of its life-threatening consequences. Education and prevention from further exposure must be addressed by health care workers. With the wealth of information on manufactures and their products, and a basic understanding of cellular immunology, the WOC nurse can facilitate the move toward either a latex-free or latex-safe environment for patients and health care staff.

Gloves, Surgical↗
PubMed1999

JCAHO accreditation considerations for the home care WOC nurse.

Driven by competition and by pressure from managed care groups, home health care organizations are increasingly choosing to seek the accreditation offered by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). WOC nurses practice in a variety of health care settings, including home health care. Many home health care organizations are now accredited, or they will choose to become accredited in the future. This article reviews home care accreditation standards as set forth by JCAHO and the possible impact of the standards on individual WOC home care nursing practice.

Community Health Nursing↗
PubMedDate not supplied

Evaluation of laser sclerostomy fistulas using ultrasound biomicroscopy.

BACKGROUND: Laser sclerostomy is a relatively new technique in glaucoma surgery. Clinical examination, particularly of the intrascleral part of laser sclerostomy fistulas, is difficult. We performed ultrasound biomicroscopy (UBM) in order to determine, if it were possible to visualize fistulas. Moreover, it was the aim to investigate whether this imaging technique could provide additional information on fistula morphology. PATIENTS AND METHODS: Ten eyes of eight patients with chronic open angle glaucoma who had undergone erbium-YAG laser sclerostomy ab externo were examined using a UBM-probe with a 20 MHz transducer providing spatial resolution of approximately 80 microm. RESULTS: Radial scanning allowed visualization of the sclerostomy fistula in nine of ten eyes. The different functional state of sclerostomy fistulas correlated well to UBM findings. It was possible to image differences in the morphology of occluded and patent fistulas and to visualize the filtering pathway in functioning blebs. CONCLUSIONS: Ultrasound biomicroscopy allows imaging of laser sclerostomy fistulas. UBM and clinical findings correlated well in the majority of the patients we examined. The technique supplements clinical examination and in some cases may provide additional information.

Aged↗
PubMed2000

Neurogenic colorectal dysfunction - use of new antegrade and retrograde colonic wash-out methods.

OBJECTIVES: To evaluate results of the Enema Continence Catheter (ECC) and the Malone Antegrade Continence Enema (MACE) applied in patients with severe neurogenic colorectal dysfunction. METHODS: The ECC was offered to 21 patients (mean age 39.9, range 7 - 72 years). The MACE was used in eight patients (mean age 32.8 years, range 15 - 66 years). All patients still using the ECC or the MACE at follow-up were interviewed. Results from patients not available for follow-up were drawn from hospital records. RESULTS: Overall success with the ECC was found in 12 of 21 patients (57%). In patients with faecal incontinence, the ECC was successful in eight out of eleven patients (73%), while four out of ten patients (40%) with constipation were successfully treated. Overall success with the MACE was found in seven out of eight patients (87%). Successful treatment with the ECC or the MACE was followed by significant improvement in quality of life. CONCLUSION: The ECC is a simple therapeutic method in severe neurogenic colorectal dysfunction. If the ECC fails the MACE, as a minor and reversible operation, is a suitable alternative to more extensive procedures.

Adolescent↗
PubMed2003

Case reports and a review of the literature on ulcers mimicking pyoderma gangrenosum.

Pyoderma gangrenosum (PG) is a rare, ulcerative skin disease. Diseases with cutaneous manifestations resembling PG may lead to the misdiagnosis of PG. We discuss two patients presenting with cutaneous ulcers originally thought to be PG, and review the literature on the clinical and pathologic characteristics of PG ulcers compared to PG-like ulcers in order to determine possible distinguishing features.

Adolescent↗
PubMed2001

The failed probing.

The management of failed probing for congenital nasolacrimal duct obstruction is given by a panel of authors. Treatment options examined are repeat probing, inferiorturbinate infracture, closed lacrimal intubation and dacryocystorhinostomy. There is considerable variation as to the timing of these interventional techniques.

Dacryocystorhinostomy↗
PubMed2002

In hydronephrosis less than 10 % kidney function is not an indication for nephrectomy in children.

PURPOSE: To reduce the incidence of nephrectomy or hydronephrosis in children. MATERIALS AND METHODS: From September 1998 to October 2000, we treated 58 patients with hydronephrosis; their ages ranged from 35 days to 11 years (mean age 4 years 7 months). All patients were subjected to a DTPA renogram with split function. In 12 patients (study group), kidney function was less than 10 % (range 0 - 10 %). Initially, nephrostomy was carried out in all 12 patients followed by Anderson-Hyne's pyeloplasty after 4 - 6 weeks. Postoperatively renal USG, urine r/m/e & c/s (routine and microscopic examination and culture and sensitivity test), blood urea, serum creatinine were assessed and DMSA scan and DTPA renogram with split functions were carried out in all patients. RESULTS: In the study group, all 12 patients showed improvement of renal function (more than 10 %) after nephrostomy and in all of them pyeloplasty was subsequently carried out within 4 - 6 weeks. There were no significant pre-, peri- or postoperative complications. CONCLUSIONS: Contrary to common practice we do not recommend nephrectomy for hydronephrotic kidneys which show < 10 % of renal function on renogram. The renal functional status improves significantly after a preliminary nephrostomy, thus avoiding the need for a straightforward nephrectomy in children along with all the possible long-term effects of a single kidney.

Child↗