Care-related Issues Research Articles

Silver Rainbows: Advances in Australian ageing and aged care

Silver Rainbows: Advances in <scp>A</scp>ustralian ageing and aged care

Exploration of nursing degree students’ content expectations of a dedicated Indigenous health unit

Summary Mandatory Aboriginal and Torres Strait Islander health units are included in all nursing education programmes in Australia to improve students' knowledge, skills and attitudes towards Indigenous people in order to help address health inequities. This research explores content expectations of nursing students required to undertake Aboriginal and Torres Strait Islander health studies as part of a Bachelor of Nursing Degree at a rural university campus. A cross-sectional survey was undertaken to examine students' opinions of course content of an Aboriginal health and wellbeing unit. Two hundred and ninety-four students across the three years of the degree were asked to complete the anonymous survey. Two hundred and forty-six students (83.6%) completed the survey. One hundred and thirty-nine students had completed, and 107 students were yet to undertake the unit. Qualitative content analysis of an open-ended survey question was used to interrogate the data. Four themes emerged from the data: cultural competence, disease implications and management, nursing care and other issues. Content expectations were consistent for students who were yet to undertake (pre) or had completed (post) the unit. Content expectations included Aboriginal and Torres Strait Islander culture (pre 30.4%–post 29.8%), Aboriginal and Torres Strait Islander health issues (pre 20.0%–post 23.7%) and understanding nursing care related issues (pre 15.7%–post 17.1%). Data findings were significant for enhancing the current unit. Students express the need for a safe learning environment in which to challenge beliefs and opinions. Course facilitators need to be sensitive to student populations and include content relevant to the programme being studied. Cultural immersion experiences may improve confidence in nursing Aboriginal and Torres Strait Islander people.

Maintaining the Heat on Neonatal Hypothermia in Developing Countries

Our world is shrinking due to computerized linkages and the mobility of society. Information is shared rapidly around the world. Issues surrounding newborn and infant nursing are global. In efforts to acknowledge the international community, each Newborn and Infant Nursing Review (NAINR) issue will feature a column that highlights care related issues from a featured country or region of the world. This article focuses on the United States. Newborn and infant health issues are global ones. To review issues occurring in different areas of the world, a different area of the globe will be featured that addresses NAINR’s theme-oriented topic. This month Australia will be featured. Our guest authors are Dr. Jann Foster and Ms. Kim Psalia, faculty from University of Sydney/University of Sydney, School of Nursing and Midwifery, Penrith, New South Wales, Australia. This article focuses on neonatal thermoregulation in low resourced or developing countries.

A case report of conjoined twin(PYGOPAGUS) separation

We report successful separation of PYGOPAGUS twins. Meticulous planning and multidisciplinary approach are the core aspects in the management of Pygopagus conjoined twins. Early elective separation versus delayed separation of the conjoined twins improves the survival from 40% to 80% . Preoperative assessment of sickle cell disease, cross-circulation and organ sharing between twins proved valuable for planning sedation and analgesia and allowing detailed scripting of the complex anesthetic induction sequence, airway management, complex neurological monitoring and post operative intensive care related issues. Fusion of lower back, spinal cord , nerve roots , and rectal and genitourinary tract was a major surgical challenge related to potentially adverse neurological outcomes, bladder /bowel dysfunction and intact long term survival. Post operative critical care issues such as pain , prone ventilation, sickle cell sequalae, cerebrospinal fluid leak and meningitis, wound infection and colostomy care, nutrition, and other potential complications are discussed in detail in this report. We emphasize the role of pediatric intensive care, preoperative planning with multidisciplinary team, and staged surgical intervention and a good postoperative care in the successful management of complicated variants.

Breastmilk: Reflections on Immunology and Importance for the Premature Infant

Our world is shrinking due to computerized linkages and the mobility of society. Information is shared rapidly around the world. Issues surrounding newborn and infant nursing are global. In efforts to acknowledge the international community, each Newborn and Infant Nursing Review (NAINR) issue will feature a column that highlights care related issues from a featured country or region of the world. This article focuses on Brazil. Newborn and infant health issues are global ones. To review issues occurring in different areas of the world, a different area of the globe will be featured that addresses NAINR's theme-oriented topic. This month Brazil will be featured. Our guest author is Dr. Marcia Maria Taveres Machado from Federal University of Ceara, Brazil. This month's article focuses on Brazil's perspective on neonatal nursing with special emphasis on breastfeeding and its relationship to the neonatal immune system.

Interprofessional Education and Practice: The Call for an Interprofessional Approach to Improve the Quality of Neonatal Care

Our world is shrinking due to computerized linkages and the mobility of society. Information is shared rapidly around the world. Issues surrounding newborn and infant nursing are global. In efforts to acknowledge the international community, each Newborn and Infant Nursing Review (NAINR) issue will feature a column that highlights care related issues from a featured country or region of the world. Newborn and infant health issues are global ones. To review issues occurring in different areas of the world, a different area of the globe will be featured that addresses NAINR’s theme-oriented topic. This month Japan will be featured. Our guest author is Ms. Wakako Eklund who is a neonatal nursing crusader and a Regional Network Contact for the Council of International Neonatal Nurses (COINN) for Japan. This month’s article focuses on the call for an interprofessional approach to improve the quality of neonatal care.

Peoples Perspective of CSR in Pakistan

Corporate social responsibility is now the legitimate concern for the future survival of the organizations. The companies that are aligned with corporate social responsibility in stake holders perspective will be competitively ahead of their competitors. All past researches focus have been on the companies perspective, what they do and how they do? First time this research was from the perspective of the people of Pakistan, what they think and expect from the companies. The data was collected from all provinces of Pakistan, Punjab, Khyber Pakhtun Khawa(KPK), Sind, Baluchistan, federal city (Islamabad), Azad Jamu Kashmir (AJK), including 24 cities of provinces. Total 5000 questionnaire were sent through mail and email to the people of all communities and departments such as Universities, colleges, schools, hospitals, parks, villages, factories, departmental stores, food streets etc. Telephone calls and self administered approach were also used to collect data and total 3275 (66%) questionnaires were received and 167 were rejected due to non conformity to research. The data was analyzed from qualified 3108 (62%) questionnaires. The data of questionnaire on 16 codes of CSR depicts that the people of Pakistan rated education number one, employment number 2, healthcare number 3 and environment protection on number four the main issues. The companies that follow the hierarchy selected by the people of Pakistan, education, employment, healthcare and environment protection will be more successful than the companies which do not follow the hierarchy. The new business entrepreneurs can take the advantage right from the start of the business by investing in education, creating more employment opportunities, investing in health care related issues and protecting the environment from pollution. The research has set a prerequisite for the new entrepreneur while considering CSR priorities in Pakistan.

International Connections: Neonatal Therapist: A South African Perspective

Our world is shrinking due to computerized linkages and the mobility of society. Information is shared rapidly around the world. Issues surrounding newborn and infant nursing are global. In effort to acknowledge the international community, each issue of Newborn and Infant Nursing Review (NAINR) will feature a column from around the globe which addresses the theme of that issue. This month's article focuses on care-related issues from a South African perspective of neonatal nursing. Our guest author is Ms Annelie van der Westhuyzen, a member of Little Steps.

Model of care and pattern of nursing practice in ambulatory oncology

The worldwide burden of cancer warrants more effective and efficient cancer care management strategies (World Health Organization, 2003). Model of ambulatory care, in particular, has tremendous implications on patient and administrative outcomes (Knight, 2007; Lynch, Marcone & Kagan, 2007; Moore, Johnson, Fortner & Houts, 2008). Nevertheless, little is known about the pattern of practices and the clinic operations in this setting. As part of the hospital's ambulatory redesign program, this survey aims to: a) review and describe existing models of ambulatory care employed by key national and international cancer centres; b) identify models or elements within the models that are appropriate to be adopted for best practice. Semi-structured interviews with 10 senior management members at 10 centres (N = 10) were conducted. Participants were asked to describe: a) model of ambulatory care employed by their institution (e.g., scope and model of ambulatory nursing practice); and b) strategies used to manage common patient care related issues in their institutions. Interviews were recorded and analyzed according to the objectives of this survey. A majority of cancer centres employed models of care similar to the existing Hospital model of ambulatory care and are encountering similar challenges in care delivery. Therefore, it was not deemed appropriate to adopt any models from participating centres. It is crucial for administrators to report and share best practices to ensure high-quality care. The survey of current practice did not yield sufficient data to adequately support the implementation of any specific models at the hospital's ambulatory care settings. Nevertheless, findings from the present review support the principles proposed for the new hospital model of ambulatory care.

International Connections: Transition From Hospital to Home: Post–Neonatal Intensive Care Unit Discharge: A Global Perspective

Our world is shrinking due to computerized linkages and the mobility of society. Information is shared rapidly around the world. Issues surrounding newborn and infant nursing are global. In efforts to acknowledge the international community, each Newborn and Infant Nursing Review issue will feature a column that highlights care-related issues from a featured country or region of the world. To review issues occurring in different areas of the world, a different area of the global will be featured that addresses the Newborn and Infant Nursing Review's theme-oriented topic. This month the column presents a global view including the United States on the topic of transition from the neonatal intensive care unit (NICU) to home and the postdischarge needs of the infant and family. Our guest author is Ms Marina Boykova, PhD(c), MSc, RN, doctoral student from the University of Oklahoma College of Nursing, Oklahoma City, OK, and a neonatal nurse from Saint Petersburg, Russia.

Community nurses' experiences of ethical problems in end‐of‐life care in the patient's own home

To gain a deeper understanding of community nurses' experiences of ethical problems in end-of-life care in the patient's own home. Ten female nurses from five different communities with experience of end-of-life care were interviewed. A hermeneutic approach inspired by Gadamer was used to analyse the qualitative data from the interviews. In the first step of interpretation, two themes emerged: Uncomfortable feelings and Lack of cooperation and in the second step, one theme Lack of security emerged. Finally, the overall interpretation revealed the theme Feelings of loss of control in end-of-life care in the patient's own home. The nurses exhibited commitment and a desire to do good when caring for patients in the end-of-life phase, even if they sometimes experienced feelings of lack of control. This implies that, when confronted with care-related issues, they have the power to both act and react. This study aimed to increase understanding of ethical problems that arise in end-of-life care in the patient's own home and revealed the need to take the patients', relatives' and nurses' perspectives on health and suffering into consideration to ensure good end-of-life home care.

Low Rates of Controller Medication Initiation and Outpatient Follow-up After Emergency Department Visits for Asthma

To determine what proportion of patients who are seen in the emergency department (ED) for asthma receive inhaled corticosteroids (ICSs) or attend follow-up appointments.The sample included a total of 3435 patients in the South Carolina Medicaid database between 2007–2009 aged 2 to 18 years with an ED visit for asthma. Patients who were in the top 99th percentile for total number of ED visits, had been admitted for asthma, or had an ICS claim in the 2 months preceding the ED visit were excluded.The study was a retrospective cohort analysis. The diagnosis of asthma was identified by using International Classification of Diseases, Ninth Revision, Clinical Modification codes. ED visits were identified by using Current Procedural Terminology codes and by an ED flag provided in the data set. Pharmacy claims filled were examined to identify ICSs, ICSs/long-acting β-agonists, and leukotriene modifiers. The primary and secondary outcomes were a pharmacy claim for any ICS or ICS/long-acting β-agonist during the month of or the month after the ED visit and any outpatient visit with a primary diagnosis of asthma within 2 months after the ED visit, respectively. Data on gender, age, race, rural residence, and asthma severity also were collected.Only 18% of the patients filled a prescription for an ICS during either the month of or the month after the ED visit, and only 12% of patients attended an outpatient follow-up appointment within the 2 months after the ED visit. In addition, only 5.2% of patients received an ICS and attended a follow-up visit for asthma. Patients aged 7 to 12 years were more likely to receive ICSs or leukotriene modifiers and attend follow-up appointments than those aged 2 to 6 or 13 to 18 years. Patients with severe asthma, as defined by ≥6 pharmacy claims for short-acting β-agonists in the calendar year of the ED visit, were more likely to receive ICSs, to receive ICSs or leukotriene modifiers, to attend follow-up appointments, and to attend follow-up appointments and receive ICSs.This study clearly demonstrates that most children in the South Carolina Medicaid population with asthma treated in the ED for an asthma exacerbation do not receive appropriate preventive care, including filling a prescription for an ICS and attending outpatient follow-up appointments.As has been demonstrated previously, this study shows that the rate of follow-up and the use of asthma controller medications after an ED visit for an asthma exacerbation are quite poor. The authors were unable to determine if ED physicians were not prescribing controller medications, if patients were not having prescriptions filled, or if a combination of factors led to a lack of controller medication use. The Medicaid population frequently uses the ED for primary care–related issues, and this study shows that measures aimed at preventing ED visits for asthma exacerbations are not being addressed adequately. Authors of future studies may consider investigating the role of the ED physician in prescribing asthma controller medications and strategies for improving adherence in this patient population.

439 Implementing a Multi-Center State-Wide Political Advocacy Program in Emergency Departments: A Feasibility Study

Study Objectives: Multiple authors have encouraged public engagement in political advocacy regarding health care-related issues. However, scant literature exists on the public's attitude towards health advocacy in a health care setting. Emergency departments (EDs) across the country have experienced dramatic increases in patient volume. EDs probably have the greatest visitor traffic throughout the hospital. Our study aims to determine if the waiting area in EDs are a feasible environment to implement a multi-center political advocacy program to influence legislation in New York State. Methods: We performed a multi-center institutional review board-approved, convenience-sample, survey-based study at several hospitals across New York State from June 2010 through April 2012. All hospitals in the New York State American College of Emergency Physicians Research Consortium were invited to participate. The study consisted of 3 stages: In Stage 1, research interns or investigators approached a convenience sample of adult English-speaking visitors in each ED waiting area to complete an anonymous 9-question survey on health care issues. Questions were extracted from a national survey (Kaiser Family Foundation/Gallup Poll, 2007). In Stage 2, visitors were offered an informational brochure concerning local and national political topics affecting health care. In Stage 3, visitors were asked to sign a letter addressed to their local legislator in support of American College of Emergency Physician (ACEP) endorsed legislation or topics. Finally, all subjects were asked to indicate whether they wanted their letter to be sent. Results: Of the 6 hospitals that had initially agreed to participate, only 3 were able to obtain full approval. The main reason for non-participation was lack of administrative support. Of the 3 participating sites, a total of 1093 subjects were approached. In Stage 1, 715 subjects (65%) agreed to complete the survey. In Stage 2, 461 (42%) subjects were willing to review health care-related literature. In Stage 3, 359 (33%) were willing to sign a letter addressed to their local legislator and 348 (32%) subjects requested the letter to be sent. Conclusion: Although administrative sensitivity to a political advocacy program may be perceived as a barrier, once in place, this program yielded significant participation from eligible visitors. Approximately one-third of visitors approached were willing to send a letter in support of ACEP endorsed legislation or policy to their legislator. EDs may be a reasonable location to implement a political advocacy program.

Review Clinical Trials

Our world is shrinking owing to computerized linkages and the mobility of society. Information is shared rapidly around the world. Issues surrounding newborn and infant nursing are global. In efforts to acknowledge the international community, each Newborn and Infant Nursing Review issue will feature a column that highlights care-related issues from a featured country or region of the world. This article focuses on Australia.

Cultural Implications: The Increase of Cesarean Delivery Rates Are Leading to Increased Incidents of Respiratory Distress in Newborn

Our world is shrinking due to computerized linkages and the mobility of society. Information is shared rapidly around the world. Issues surrounding newborn and infant nursing are global. In efforts to acknowledge the international community, each Newborn and Infant Nursing Review issue will feature a column that highlights care-related issues from a featured country or region of the world. This article focuses on Puerto Rico. Newborn and infant health issues are global ones. To review issues occurring in different areas of the world, a different area of the globe will be featured that addresses a Newborn and Infant Nursing Review's theme-oriented topic. This month, Puerto Rico will be featured. Our guest author is Ms Yolanda Nitti, RN, MSN, a faculty member at Miami Dade College–Medical Campus in Miami, Florida. This month's article focuses on “Cultural; Implications: The Increase of Cesarean Delivery Rates Are Leading to Increased Incidents of Respiratory Distress in Newborn.”

Neuroprotective Strategies for Hypoxic Ischemic Encephalopathy

Our world is shrinking due to computerized linkages and the mobility of society. Information is shared rapidly around the world. Issues surrounding newborn and infant nursing are global. In efforts to acknowledge the international community, each Newborn and Infant Nursing Review issue will feature a column that highlights care-related issues from a featured country or region of the world. This article focuses on the United States. Newborn and infant health issues are global ones. To review issues occurring in different areas of the world, a different area of the globe will be featured that addresses the Newborn and Infant Nursing Review's theme-oriented topic. This month the United States will be featured. Our guest author is Ms Leslie Parker PhD, NNP-BC, Clinical Assistant Professor, College of Nursing at the University of Florida and a Regional Network Contact for the Council of International Neonatal Nurses for the United States. This month's article focuses on the hypoxic ischemic encephalophathy.

Multiples in the Newborn Intensive Care Unit: Parents' and Nurses' Perspectives

Our world is shrinking because of computerized linkages and the mobility of society. Information is shared rapidly around the world. Issues surrounding newborn and infant nursing are global. In efforts to acknowledge the international community, each Newborn and Infant Nursing Review issue will feature a column that highlights care-related issues from a featured country or region of the world. This article focuses on Northern Ireland. Newborn and infant health issues are global ones. To review issues occurring in different areas of the world, a different area of the globe will be featured that addresses Newborn and Infant Nursing Review's theme-oriented topic. This month, Northern Ireland will be featured. Our guest author is Sharon Nurse, BSc (Hons), RN, RM, RCNT, and Regional Network Contact for the Council of International Neonatal Nurses for Ireland. This month's article focuses on multiple births.

Understanding HTM 01-05

Dental NursingVol. 7, No. Sup1 ForewordUnderstanding HTM 01-05Bev WaspBev WaspSearch for more papers by this authorBev WaspPublished Online:18 Nov 2013https://doi.org/10.12968/denn.2011.7.Sup1.3AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Department of Health (2009) Health Technical Memorandum 01-05: Decontamination in primary care dental practices. DH, London Google ScholarDepartment of Health and Infection Prevention Society (2009) Local self-assessment audit for assessing implementation of HTM 01-05:decontamination in primary care dental practices and related infection prevention and control issues. www.dhsspsni.gov.uk/htm_01-05_audit_tool.pdf (accessed 27 July 2011) Google ScholarDepartment of Health (2010) The Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance. DH, London Google Scholar FiguresReferencesRelatedDetails 1 September 2011Volume 7Issue Sup1ISSN (print): 1749-6799ISSN (online): 1759-7404 Metrics History Published online 18 November 2013 Published in print 1 September 2011 Information© MA Healthcare LimitedPDF download

International Column: Effects of Humanitarian Emergencies on Newborn and Infants' Health in Pakistan

Our world is shrinking because of computerized linkages and the mobility of society. Information is shared rapidly around the world. Issues surrounding newborn and infant nursing are global. In efforts to acknowledge the international community, each Newborn and Infant Nursing Review issue will feature a column that highlights care-related issues from a featured country or region of the world. This article focuses on Pakistan. Newborn and infant health issues are global ones. To review issues occurring in different areas of the world, a different area of the globe will be featured that addresses Newborn and Infant Nursing Review's theme-oriented topic. This month, Pakistan will be featured. Our guest author is Ms Shela Akbar Ali Hirani, MScN, BScN, and Regional Network Contact for the Council of International Neonatal Nurses for Pakistan. This month's article focuses on the effects of humanitarian emergencies on infants' health.

Timing in adjuvant chemotherapy (CTX) initiation among women with breast cancer (BC) at National Comprehensive Cancer Network (NCCN) centers: An analysis from the NCCN Outcomes Database.

6022 Background: Receipt of quality care has two important dimensions: that patients receive both appropriate and timely care. The primary aim was to examine time from BC diagnosis to CTX and identify factors associated with longer time. Methods: In the NCCN Outcomes Database, we identified 5,583 women with stage I-III BC diagnosed in 2003-2008 who received adjuvant CTX at 10 NCCN centers within 32 weeks (wks) of diagnosis. Patients with neoadjuvant therapy were excluded. Multivariate ANCOVA models were constructed to examine adjusted mean Time to Chemotherapy (TTC) from the date of pathological diagnosis. Results: Mean TTC was 11.8 wks. Many sociodemographic and clinical factors were associated with longer TTC. Factors with the largest effects are listed in Table 1. Minimal prolongation of TTC was associated with initial mastectomy versus lumpectomy (3 day greater TTC, p=0.01). Greater prolongation of TTC was observed between Caucasian and African American (AA) women diagnosed at another center prior to presentation (2.1 wks, p<0.001) than at the NCCN center (1.0 wk, p=0.13), and among patients with Medicare (2.7 wks, p<0.001) versus Managed Care (MCO, 1.2 wks, p<0.001) or Medicaid (0.9 wks, p=0.99). Interactions were significant between ethnicity and both insurance (p=0.03) and diagnosing institution (p=0.02). Conclusions: Some delay in TTC associated with clinical factors (21 gene RT PCR assay or number of excisions) may be unavoidable but should be minimized. Opportunities for improvement at the system level (insurance and transfers in care) were observed. Observed disparity in TTC for AA women appears to be exacerbated by transferring care and insurance related issues. % patients Mean TTC difference, wks Race/ethnicity Caucasian 78 Ref Hispanic 7 +0.7** AA 9 +1.6*** Asian 4 0.5 Other 2 0.0 Insurance MCO 78 Ref Medicare 10 +0.6* Medicaid 7 +2.6*** Other 4 0.4 Diagnosing institution NCCN 26 Ref Non-NCCN 74 +1.2*** Excisional procedures 1 64 Ref 2 31 +2.1*** ≥3 5 +5.6*** Reconstruction prior to CTX No 82 Ref Yes 18 +2.5*** 21-gene RT PCR assay No 94 Ref Yes 6 +2.2*** *p<0.05, **p<0.01, ***p<0.001