Author Archives: Amy

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About Amy

Clinical Informationist at EUH Branch Library

Is smoke from electrosurgical devices associated with health hazards?

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Bottom line:

Details: NIOSH Health Hazard Evaluation Report: HETA #2001-0066-3019, Morton Plant Hospital Dunedin, Florida
A report of investigation performed at an individual hospital. It documents the smoke generated by electrosurgical devices and references studies on effects of exposure to components of surgical smoke (pp. 4-8).

PubMed
A collection of AORN guidelines, reviews and one cohort study (Gates 2007) on smoke in the operating room. Use the link below to access the results of the search.
Search: (“Inhalation Exposure”[Mesh] OR “Occupational Exposure”[Mesh] OR “Smoke”[Mesh] OR “Air Pollutants”[Mesh]) AND (cautery OR electrosurgery) AND (cohort study OR follow-up OR “research support”

Also, see these review articles in PubMed.

SEARCH METHOD
CDC’s National Institute for Occupational Safety and Health (NIOSH) website
Search using the term electrosurgery

PubMed
Search using different combinations of these concepts:
Problem: electrosurgery, cautery
Exposure: smoke, air pollutants, inhalation, occupational exposure – all of these have medical subject headings in PubMed
Outcome: adverse effects
Methodology: cohort studies, follow-up, research support

Do nurse managed heart failure clinics have an effect on readmission or cost avoidance for hospital systems?

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Bottom line:  Results from some quasi-experimental studies (mostly quality improvement projects) reported reductions in readmissions, cost, or length of stay for patients participating in nurse-directed heart failure clinics.

Details:  Search results in CINAHL for search of (MH “Nurse-Managed Centers”) AND heart failure AND (readmission OR readmissions OR cost OR costs)

Display relevant references in PubMed.

Reviewed and updated 5/1/2014 ldt

What is the recent evidence for intentional rounds in the intensive care unit?

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Searched CINAHL and PubMed for patient rounds AND (“intensive care” OR “critical care”)  with a limit of English.

Six quasi-experimental studies in CINAHL measuring nurse satisfaction, ventilator-associated pneumonia, cental-line associated bloodstream infection, nosocomial infections, healthcare outcomes, family presence, and facilitators and barriers to patient care rounds
Adding intensive care or critical care eliminates many studies that may also be relevant.

(MH “Patient Rounds”) AND (hourly OR intentional OR proactive OR comfort)
These results include several experimental and quasi-experimental studies. If you want to look at specific outcomes, see the following searches for particular topics:

Falls – (MH “Patient Rounds”) AND (hourly OR intentional OR proactive OR comfort) AND falls

Patient satisfaction – (MH “Patient Rounds”) AND (hourly OR intentional OR proactive OR comfort) AND patient satisfaction

Patient centered care – (MH “Patient Rounds”) AND (MH “Patient centered care”)

Papers in PubMed search: (rounds OR rounding) AND (intentional OR hourly OR time factors OR proactive) AND (nurses OR nursing) AND (safety OR quality improvement OR infection OR pneumonia OR pressure ulcers OR falls OR patient satisfaction OR patient outcome assessment OR outcomes assessments) AND (“intensive care” OR “critical care”)
This search retrieves papers examining common outcomes in the intensive care unit.  Other outcomes can be included in the search.

Reviewed and updated 5/1/2014 ldt

Are there systematic reviews of the evidence about the effect of chlorhexidine on rate of catheter associated urinary tract infections?

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Joanna Briggs Institute’s JBI+COnNECT, an evidence summary source, has published this evidence summary:  Urethral Catheter (Indwelling Short-Term):  Urinary Tract Infection Prevention

The Clinical Bottom Line section summarizes evidence on various care regimens, including daily cleaning.  Two relevant statements:
“Daily cleansing of the urethral meatus using soap and water or perineal cleanser has been shown to be effective to reduce CAUTI.3 (Level II)”
“The following interventions are not deemed effective for reducing CAUTI incidence: sterile technique for catheter insertion, use of antiseptic solutions or ointment during routine meatal care, 2-chambered urinary drainage bags, antiseptic filters incorporated into the drainage bag, bladder or catheter irrigation, frequent urinary drainage bag changes and placing an antiseptic solution into the urinary drainage bag.3 (Level I)”

References to other systematic reviews are available through this PubMed search: chlorhexidine AND urinary tract infection AND catheter AND (systematic review OR meta-analysis)

What is the standard of care for a patient with cryptogenic organizing pneumonia, i.e., “BOOP”, and how is it related to acute respiratory distress syndrome?

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Cryptogenic organizing pneumonia (COP)  is a form of idiopathic interstitial pneumonia, and the DynaMed Plus entry for Interstitial Lung Disease will provide details about clinical presentation and treatment.  Look in the Treatment section for details.  The Treatment Overview includes links to Corticosteroid therapy and a section for Cause-Specific Therapy (on menu on the left side of the screen) for Other Idiopathic Interstitial Pneumonias.

Acute Respiratory Failure.  In:  Conn’s Current Therapy, 2017.
Includes a discussion of clinical presentation and causes of ARDS, as well as conditions that can mimic ARDS, including COP.

Updated 10/12/2017 ldt

What is the evidence on actively engaging nurses at bedside shift report?

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Joanna Briggs Institute’s JBI+COnNECT, an evidence summary source, has published this evidence summary on clinical handover.
Good overview of evidence, but nothing specifically on nurses’ attitudes or how to actively engage nurses in bedside shift report specifically.

PubMed
bedside shift AND (report OR round* OR handover) AND (attitudes OR (nurses AND psychology))
The articles below are from the PubMed search and describe implementation of or changes to shift reports and may be most helpful.

1: Chaboyer W, McMurray A, Wallis M. Bedside nursing handover: a case study. Int
J Nurs Pract. 2010 Feb;16(1):27-34. PubMed PMID: 20158545.

2: Staggers N, Jennings BM. The content and context of change of shift report on
medical and surgical units. J Nurs Adm. 2009 Sep;39(9):393-8. PubMed PMID:
19745636.

3: Athwal P, Fields W, Wagnell E. Standardization of change-of-shift report. J
Nurs Care Qual. 2009 Apr-Jun;24(2):143-7. PubMed PMID: 19287253.

4: Caruso EM. The evolution of nurse-to-nurse bedside report on a
medical-surgical cardiology unit. Medsurg Nurs. 2007 Feb;16(1):17-22. PubMed
PMID: 17441625.

5: Anderson CD, Mangino RR. Nurse shift report: who says you can’t talk in front
of the patient? Nurs Adm Q. 2006 Apr-Jun;30(2):112-22. PubMed PMID: 16648723.

6: Philpin S. ‘Handing over’: transmission of information between nurses in an
intensive therapy unit. Nurs Crit Care. 2006 Mar-Apr;11(2):86-93. PubMed PMID:
16555756.

7: Manias E, Street A. The handover: uncovering the hidden practices of nurses.
Intensive Crit Care Nurs. 2000 Dec;16(6):373-83. PubMed PMID: 11091469.

CINAHL search:  bedside AND shift AND (report OR round* OR handover) AND (attitudes OR (nurses AND psychology))
Limited to English and Peer-reviewed,   Excluded records that are also in Medline (PubMed)
Retrieved one additional record that includes a survey of nurses’ attitudes.
Communication at the bedside to enhance patient care: A survey of nurses’ experience and perspective of handover.Detail Only Available (includes abstract); Street, Maryann; Eustace, Paula; Livingston, Patricia M; Craike, Melinda J; Kent, Bridie; Patterson, Denise; International Journal of Nursing Practice, 2011 Apr; 17 (2): 133-40.

The fulltext for this article is available through the JBI+  journals page.

What are the signs and symptoms of lupus and mononucleosis?

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DynaMed provides this type of information for disease states. Each link below will take you to a summary of information on that disease. Use the menu on the left side of the screen to navigate to the History and Physical Sections for signs and symptoms.

Systemic lupus erythematosus (SLE)

Infectious mononucleosis

DynaMed and other point-of-care information resources are available on the Nursing Community of the Health Sciences Center Library’s website.