Clinical nursing research
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Clinical nursing research · May 2021
Meta AnalysisThe Delirium Observation Screening Scale: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy.
Delirium is a reversible impairment of metabolism in the human brain. Early detection is important, and an effective screening tool for nurses is crucial. The Delirium Observation Screening (DOS) scale is one such screening tool; however, its diagnostic test accuracy has not yet been thoroughly examined. ⋯ In July 2019, a search was conducted in the MEDLINE, CINAHL, Embase, and PsycARTICLES databases, and following a review against pre-defined eligibility criteria, eight studies were finally included. The quality assessment tool of diagnostic accuracy studies was applied to each study and a hierarchical regression model was used to calculate the pooled estimates of sensitivity (90%; 76%-97%, CI 95%) and specificity (92%; 88%-94%, CI 95%). The findings indicated a high diagnostic test accuracy for the DOS scale.
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Clinical nursing research · Dec 2017
ReviewExtracorporeal Membrane Oxygenation (ECMO) for Lung Injury in Severe Acute Respiratory Distress Syndrome (ARDS): Review of the Literature.
Despite advances in mechanical ventilation, severe acute respiratory distress syndrome (ARDS) is associated with high morbidity and mortality rates ranging from 26% to 58%. Extracorporeal membrane oxygenation (ECMO) is a modified cardiopulmonary bypass circuit that serves as an artificial membrane lung and blood pump to provide gas exchange and systemic perfusion for patients when their own heart and lungs are unable to function adequately. ⋯ In critical care settings, ECMO is proven to improve survival rates and outcomes in patients with severe ARDS. This review defines severe ARDS; describes the ECMO circuit; and discusses recent research, optimal use of the ECMO circuit, limitations of therapy including potential complications, economic impact, and logistical factors; and discusses future research considerations.
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Clinical nursing research · Feb 2012
ReviewAnalysis of measurement tools of fear of falling for high-risk, community-dwelling older adults.
Fear of falling has many health consequences among older adults and may lead to curtailment of activities, immobility, functional dependence, falls, and serious injury. The lack of clarity as to how to best measure fear of falling among high-risk, community-dwelling older adults defined as those who are nursing home eligible, functionally dependent, and vulnerable is further complicated by the multiple definitions used throughout the science. Fear of falling is important to measure effectively if we are to develop and test interventions to promote safe aging in place and prevent injury and institutionalization. This integrative review, 1982 to the present, leads to the conclusion that the Falls Efficacy Scale-International (FES-I) long form stands out as the most appropriate measurement tool to best assess fear of falling in this unique, understudied, and underserved population.
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Clinical nursing research · May 2000
ReviewValidity and reliability of a practice-based infant pain assessment instrument.
The purpose of this study was to determine the validity and reliability of an infantpain assessment instrument. This instrument is an algorithm derived from a model of infant pain assessment that emerged from interviews with pediatric nurses and includes methods for evaluating clinical data that suggest the Iikelihood of pain. Unlike other instruments, this instrument is not restricted to use in clinical situations where the likelihood of pain is evident. ⋯ Content validity was determined by obtaining and incorporating feedback from a focus group of practicing pediatric nurses on various developmental stages of the instrument. Criterion-like validity was excellent: Mean Pearson correlations between the pain ratings of 18 videotaped infants by 24 nursing students using the instrument with ratings performed by a panel of 5 expert nurses not using any instrument was 0.96. Test-retest reliability, as measured by Pearson correlations between pain ratings 3 months apart, was also excellent (r = 0.91).