British journal of nursing (Mark Allen Publishing)
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Randomized Controlled Trial Multicenter Study Comparative Study
Nurses' views on ease of patient care in postoperative pain management.
The fentanyl HCl iontophoretic transdermal system (ITS) is a compact, needle-free, pre-programmed patient-controlled analgesic system that was developed to address limitations to existing therapies for postoperative pain management. A randomized, controlled trial was conducted in 11 European countries to evaluate the efficacy and safety of postoperative pain control using fentanyl ITS compared with a standard regimen of morphine provided by an intravenous patient-controlled analgesia (IV PCA) pump. ⋯ Nurses' ratings of patient-care tasks associated with each pain management system were significantly more favourable for fentanyl ITS than for morphine IV PCA. These findings suggest that nurses consider fentanyl ITS to be easier to use than morphine IV PCA.
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The recent epic2 publication (Pratt et al, 2007) provides evidence-based guidelines for the prevention of healthcare-associated infections. One of the new recommendations related to the prevention of central venous catheter (CVC) associated infection states that 2% chlorhexidine gluconate (CHG) in 70% isopropyl alcohol (IPA) should be used for cutaneous antisepsis prior to device insertion. This article reviews cutaneous antisepsis prior to intravascular catheter placement.
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What are the implications of caring for patients with advance directives in emergency care contexts? This paper examines legal and professional perspectives and highlights the challenges that practitioners face. Emergency care contexts necessitate the need for timely decision making regarding care and treatment options. ⋯ They are also legally binding documents and represent the wishes of a patient, but often with little prior knowledge of the patient, practitioners may be unsure whether to act on an advance directive. This paper makes some attempt to examine key components of this debate.
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Nursing a patient in pain is a challenging task requiring up-to-date knowledge, skilled interventions and attitudes that convey trust, care and an honest belief in what the patient says (Carr, 1997). This study examined the knowledge and attitudes of nurses who have completed a knowledge and competency training programme within an orthopaedic centre (Group one) against a group of nurses who were attending a pain conference who had not completed this programme (Group two). ⋯ Findings from the survey revealed that there was no significant difference in the total correct responses between the two groups and there was a severe deficit in knowledge relating to questions about non-pharmacological methods of treating pain and opioid use in chronic pain conditions. However Group one had a higher correct response rate (p=0.001) in the vignettes that are based on daily nursing practice.