Monthly Archives: September 2014

What are the patient safety concerns for administration of epoprostenol?

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Kingman, Martha S.; Chin, Kelly. Safety Recommendations for Administering Intravenous Prostacyclins in the Hospital.
Critical Care Nurse (CRIT CARE NURSE), 2013 Oct; 33 (5): 32-41. (37 ref)

Fuentes, Amaris; Coralic, Aida; Dawson, Kyle L. A new epoprostenol formulation for the treatment of pulmonary arterial hypertension. American Journal of Health-System Pharmacy (AM J HEALTH SYST PHARM AJHP), 2012 Aug 15; 69 (16): 1389-93.

Buckley, Mitchell S, et al. “Clinical utility of treprostinil in the treatment of pulmonary arterial hypertension: an evidence-based review.” Core evidence 9(2014):71-80.

Sitbon, Olivier, et al. “EPITOME-2: An open-label study assessing the transition to a new formulation of intravenous epoprostenol in patients with pulmonary arterial hypertension.” The American heart journal 167.2 (2014):210-7.

Shirai, Yuichiro, et al. “Intravenous epoprostenol treatment of patients with connective tissue disease and pulmonary arterial hypertension at a single center.” Modern rheumatology 23.6 (2013):1211-20.

Fuentes, Amaris, Aida Coralic, and Kyle L. Dawson. “A new epoprostenol formulation for the treatment of pulmonary arterial hypertension.” American journal of health-system pharmacy 69.16 (2012):1389-93.

Oudiz, Ronald J, and Harrison WFarber. “Dosing considerations in the use of intravenous prostanoids in pulmonary arterial hypertension: an experience-based review.” The American heart journal 157.4 (2009):625-35.

DynaMed Entry for ” target=”_blank”>Epoprostenol
On the left look at Dosage and Administration and Cautions and Adverse Effects

Searched PubMed, DynaMed, and CINAHL. Keywords: Epoprostenol, patient safety, administration

What is the effect of music therapy on pain (or stress reduction) during dressing changes?

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The majority of search results focused on music therapy reducing pain or stress during dressing changes in burn patients.

Evidence Summaries

Joanna Briggs

Burns Pain (Adults): Non-Pharmacological Management. Miller, Kate [BOccTh PhD]. Kipping, Belinda [BOccTh MPhil]. Gray, Paul [MBBS PhD FANZCA FFPMANZCA]. Schug, Stephan. Munn, Zachary [PhD]. [Recommended Practices] 2014

This study reports that  generally there is a lack of high quality evidence for nonpharmacological  interventions reducing stress or pain in burn patients.

Literature search in PubMed was more specific to music therapy:

My search strategy was  (“Bandages”[Mesh] OR bandages OR biological dressings OR occlusive dressings) AND music therapy AND (pain OR stress)

Tan, Xueli, et al. “The efficacy of music therapy protocols for decreasing pain, anxiety, and muscle tension levels during burn dressing changes: a prospective randomized crossover trial.” Journal of burn care & research 31.4 (2010):590-7.

Nilsson, S, and A-CRenning. “Pain management during wound dressing in children.” Nursing standard 26.32 (2012):50-5.

Protacio, Judith. “Patient-directed music therapy as an adjunct during burn wound care.” Critical care nurse 30.2 (2010):74-6.

Cole, Linda C, and GeriLoBiondo Wood. “Music as an adjuvant therapy in control of pain and symptoms in hospitalized adults: a systematic review.” Pain management nursing 15.1 (2014):406-25.

See addititonal PubMed references by clicking on this link:

 http://www.ncbi.nlm.nih.gov/sites/myncbi/collections/public/1PQtun_Aiz3ViSsu-3u3inwQm/

Searching other databases like CINAHL and PsycINFO did not produce any new results.

See also this post in the blog:

Effectiveness of music therapy as an adjunct to pharmacological pain relief in post-op patients

 

 

What is the evidence linking disposable ECG cables and lead wire systems to decreased hospital acquired infections (HAIs)? What would the cost savings be?

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Studies focus on identifying presence of bacteria on devices, as opposed to devices being associated as the cause of HAI cases.  Likewise, no published literature was identified that specifically demonstrated that use of disposable leads reduces the rate of HAIs.

Evidence Summary sources:

Joanna Briggs
Xue, Yifan. Noninvasive Portable Clinical Items: Healthcare Associated Infections. [Evidence Summaries]. JBI11266, 2014.
Cites studies demonstrating the prevalence of low-risk, potentially pathogenic, and multidrug resistant bacteria on non-invasive devices, including ECG lead wires.

Literature databases:

PubMed:  cross infection AND (electrocardiography OR noninvasive devices) AND (disposable OR reusable OR reuse OR “single use”)

Microbial colonization of electrocardiographic telemetry systems before and after cleaning.
Reshamwala A, McBroom K, Choi YI, LaTour L, Ramos-Embler A, Steele R, Lomugdang V, Newman M, Reid C, Zhao Y, Granger BB.
Am J Crit Care. 2013 Sep;22(5):382-9. doi: 10.4037/ajcc2013365.
PMID: 23996417
contamination after cleaning reusable leads

Disposable vs reusable electrocardiography leads in development of and cross-contamination by resistant bacteria.
Brown DQ.
Crit Care Nurse. 2011 Jun;31(3):62-8. doi: 10.4037/ccn2011874.
PMID: 21632593
Review article

Cleaned, ready-to-use, reusable electrocardiographic lead wires as a source of pathogenic microorganisms.
Albert NM, Hancock K, Murray T, Karafa M, Runner JC, Fowler SB, Nadeau CA, Rice KL, Krajewski S.
Am J Crit Care. 2010 Nov;19(6):e73-80. doi: 10.4037/ajcc2010304.
PMID: 21041188
presence of pathogens on reusable leads

Potential micro-organism transmission from the re-use of 3M Red Dot adhesive electrocardiograph electrodes.
Daley AJ, Hennessy D, Cullinan J, Thorpe S, Alexander R.
J Hosp Infect. 2005 Nov;61(3):264-5. Epub 2005 Jul 5. No abstract available.
PMID: 16002182

CINAHL

A similar search of CINAHL did not identify any unique, relevant articles.

Cost savings

The cost savings of decreasing HAIs can be calculated by multiplying the estimated cost of  an HAI by the number of HAIs in a given period of time.  Then, subtract the cost of disposable equipment for all procedures occurring during that time period (i.e., the number of disposable cables that would be used with patients).

The CDC provides data on estimated cost of HAIs.  Start at http://www.cdc.gov/hai/surveillance/. The Direct Medical costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention, 2009, includes estimates for specific types of infections beginning on p. 5.

Learning style and nursing preceptorship

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Do different pairings of teaching styles and learning styles make a difference? Preceptor and resident perceptions.
Teaching and learning in medicine [1040-1334] yr:2008 vol:20 iss:3 pg:239

“Impact of preceptor and orientee learning styles on satisfaction: a pilot study.” Journal for nurses in staff development 23.1 (2007):36.

Preceptorship planning is essential to perioperative nursing retention: matching teaching and learning styles.
Canadian Operating Room Nursing Journal [0712-6778] yr:2010 vol:28 iss:1 pg:8

Learning style theories: matching preceptors, learners, and teaching strategies in the perioperative setting.
Seminars in perioperative nursing [1056-8670] yr:2001 vol:10 iss:4 pg:184

“Orientation with style: matching teaching/learning style.” Journal for nurses in staff development 14.4 (1998):192.

Jasmine, Lee Xin Yu. Registered nurses’ perception of their preceptor role towards pre-registration nursing students during clinical placement: A systematic review.. [Systematic Review Protocols] AN: JBI4677

Joyce . Faculty strategies that influence the student transition from registered nurse to nurse practitioner: a systematic review protocol 2014 vol:12 iss:5 pg:34 -41

Searched CINAHL and Joanna Briggs using keywords: preceptorship, learning style.

What evidence dated within the last ten years is there on use of sweet oral substances to alleviate discomfort in infants?

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Twelve systematic reviews and meta-analyses dated within the last 10 years are found with a search in PubMed. Here’s how to conduct this search.

  1. You may start with the Woodruff Health Sciences Center Library homepage at http://health.library.emory.edu/ and then click “PubMed” or you may use this direct link to Emory’s instance of PubMed at http://www.ncbi.nlm.nih.gov/sites/entrez?otool=emorylib
  2. Copy and paste this search into the search box and click “Search.”infant AND (oral administration OR chewing gum) AND (pain management OR (pain AND (male circumcision OR intravenous injection OR blood specimen collections OR punctures))) AND (sucrose OR sweetening agents)
  3. To impose the filter/limit of 10 years, click “10 years” to the left of the search results page (listing of articles found with the search).
  4. To impose the filter/limit of meta-analysis or systematic review, click “More” under the bold heading for “Article types” on the left side of the search results page. Then click the boxes beside “Meta-Analysis” and “Systemic Reviews” and click “Show.” This step made the filters/limits visible for use in the search. Then click “Meta-Analysis” and “Systematic Review” to impose these filters/limits on the current search.