Journal of vascular nursing : official publication of the Society for Peripheral Vascular Nursing
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The aim of this study was to describe patients' experiences 5 years after being informed about having an abdominal aortic aneurysm (AAA), at screening, in a subgroup of patients who suffered a decrease in quality of life (QoL) 12 months after screening. Of 6 patients with a decreased QoL 12 months after AAA screening, one had died, one declined to participate and one suffered cognitive problems and was therefore excluded. The remaining 3 patients (all men, aged 79-80 years) were interviewed in their homes. ⋯ Furthermore, the patients experience having an AAA to be symbolically 'like a drop in the ocean.' This means having no physical problems related to AAA, and having more difficulties with other diseases or problems in life overshadows the awareness about the AAA. An observed reduction in QoL among subjects with screening-detected AAA was mainly explained by other diseases or problems that overshadow the AAA. However, the low number of participants indicates a need for extended studies on this topic.
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Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is a serious cause of patient morbidity and mortality in hospitals, that is highly preventable. Literature strongly supports patient education on VTE prevention as it can promote strategies such as early ambulation and encourages self assessment and self reporting of VTE signs and symptoms. The purpose of this study was to investigate patient awareness and knowledge of thromboprophylaxis, as well as patient satisfaction with thromboprophylaxis. ⋯ Participants were satisfied with pharmacological thromboprophylaxis but were less satisfied with the information received on VTE. Findings suggest that patients require further information on VTE during their hospitalization to enhance their involvement in VTE prevention and recognition, and that the provision of written, patient-directed information could begin to address that lack of involvement. This study also highlights the need to strengthen the nurses' role in providing patient education about VTE.
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We studied prolonged length of stay (LOS) in the acute care setting on a medical-surgical vascular unit, related to loss of functional mobility status after lower extremity amputation, and implementation of the Amputee Mobility Protocol (AMP) as a standard of care for all patients pre- and post-lower extremity amputation who were admitted to the medical-surgical vascular unit. A comparative pre-post observational study evaluated the effect of AMP on level of functional mobility and LOS after lower extremity amputation in the patient population on the medical-surgical vascular unit. Data was collected retrospectively from patient chart reviews from November of 2004 to March of 2005 for the pre-AMP group and through concurrent patient chart reviews from November of 2005 to March of 2006 for the post-AMP group. ⋯ This pilot study relates to 3 of the top 20 vascular research priorities: 1) an interdisciplinary strategy to improve the patient's level of functional independence and thereby decrease LOS and cost; 2) the nursing intervention of early, predetermined ambulation schedules will increase the nursing knowledge of strategies that facilitate recovery after vascular surgery in this population; and 3) factors that affect patient outcomes after these three major vascular procedures will be addressed in pilot outcomes. Limitations of the AMP pilot study included the small sample size, staff turnover, and lack of a concurrent control group. The next phase of this project will create and implement a similar activity protocol for patients after abdominal aortic aneurysm repair and various types of lower extremity bypass procedures.
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The majority of in-hospital cardiac arrests are preceded by observable indicators of deterioration within hours of the event. It is generally accepted that cardiac arrest occurs in response to cardiac arrhythmias, hypotension, and acute respiratory changes. Numerous research studies support that early recognition and prompt treatment of the early indicators of these conditions are associated with improved clinical outcomes and reduced mortality. ⋯ Health care quality initiatives, such as the 100,000 Lives Campaign and Preventing 5 Million Lives from Harm, advocate the use of rapid response teams in acute care facilities as a method to facilitate early recognition and management of patients at risk for cardiac arrest. One year after the implementation of a rapid response team at our academic tertiary care facility, the incidence of code blue events outside of the intensive care unit was reduced by 9% and overall mortality was reduced by 0.12%. This article will discuss the experience of developing, implementing, and evaluating outcomes associated with a rapid response team using a nurse-to-nurse consult approach.