International journal of nursing studies
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End-stage chronic obstructive pulmonary disease (COPD) is a debilitating, life-limiting condition. A palliative approach is appropriate for individuals with end-stage COPD, yet currently few interventions embrace this holistic, multidisciplinary and inclusive perspective. ⋯ Further investigation is required to address the complex personal, provider and system elements associated with managing end-stage COPD. A comprehensive and collaborative approach is required to address the complex and varied needs of individuals with end-stage COPD and their families.
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Randomized Controlled Trial
Effect of continuous oral suctioning on the development of ventilator-associated pneumonia: a pilot randomized controlled trial.
Both continuous and intermittent aspiration of subglottic secretions by means of specially designed endotracheal tubes containing a separate dorsal lumen that opens into the subglottic region have been shown to be useful in reducing ventilator-associated pneumonia (VAP). However, the high cost of these tubes restricts their use. ⋯ Continuous clearance of oral secretion by the saliva ejector may have an important role to play in reducing the rate of VAP, decreasing the duration of mechanical ventilation, and shortening the length of stay of patients in the ICU.
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The development of pressure ulcers (PUs) impacts quality of life among home care (HC) recipients and increases overall healthcare costs. ⋯ To decrease the development of developing pressure ulcers in new HC recipients, nurses should educate primary caregivers regarding strategies for preventing PUs during potential HC recipient hospitalization. HC nurses should assess PU prevention care of primary caregivers, in addition to assessing the risk of developing PUs by the Braden scale.
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International studies have shown that motivation and career considerations related to nursing reveal that the decision is determined by a multitude of factors, generally distinguishing between the extrinsic and intrinsic rewards and work values. Although changing values seem to be important with greater emphasis on personal development and a reduction in other-orientation and altruism, nursing still stress the caring component with a desire to help and care for others. ⋯ The majority of the Mauritian nurses in the sample had a more pragmatic and materialistic approach to the nursing profession and hardly any emphasis on caring and a desire to help others. Nursing was considered a gender neutral occupation and a job like any other jobs. Entering the nursing profession is regarded as the achievement of considerable social mobility taken into account the predominantly working class background of most nurses.
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Pain continues to be a common problem for older hospitalised patients, but little is known about how the complexities of actual clinical practice affect pain assessment and management in these patients. ⋯ This study demonstrated the intricacies associated with how analgesic needs are addressed in older patients, especially those with communication deficits, the complex nature of older patients' painful experiences, and the precarious balance of attempting to treat pain effectively while avoiding adverse effects of analgesics.