Articles: adult.
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Reg Anesth Pain Med · Jan 2016
Real-Time Captioning for Improving Informed Consent: Patient and Physician Benefits.
New methods are needed to improve physicians' skill in communicating information and to enhance patients' ability to recall that information. We evaluated a real-time speech-to-text captioning system that simultaneously provided a speech-to-text record for both patient and anesthesiologist. The goals of the study were to assess hearing-impaired patients' recall of an informed consent discussion about regional anesthesia using real-time captioning and to determine whether the physicians found the system useful for monitoring their own performance. ⋯ Real-time speech-to-text captioning improved recall in hearing-impaired patients and proved useful for determining the information provided during an informed consent encounter. Real-time speech-to-text captioning could provide a method for assessing physicians' communication that could be used both for self-assessment and as an evaluative approach to training communication skills in practice settings.
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Opioid-based analgesic therapy represents a cornerstone of pain management after surgery. The recent rise in opioid sales and opioid overdoses suggests it is important to maximize the safety of opioid prescribing after surgery. Given that patients may live with other family members in the home, safe storage and appropriate disposal of excess opioids after hospital discharge are necessary to prevent unintended secondary exposures. Identifying characteristics of patients who are likely to be prescribed excess opioids after surgery may enable more targeted prescription practices and safety interventions. Our study aimed to elucidate patient-reported opioid use patterns and modes of home storage of opioids among patients discharged home after Cesarean section (C-section) and thoracic surgery. Specifically, we sought to identify characteristics of patients who reported using about half or more versus less of the opioids prescribed to them for use after hospital discharge. ⋯ Our findings from surveys in two distinct patient populations at a single academic medical center suggest that current opioid prescribing practices for pain management at hospital discharge following Cesarean section and thoracic surgery may not account for individual patients' analgesic requirements. Excess opioid pills are commonly stored in unsecured locations and represent a potential source for non-medical opioid use and associated morbidity and mortality in patients and their families. Research to develop goal-directed and patient-centered post-discharge opioid prescription practices and encourage opioid safety practices after surgery is needed.
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Dimens Crit Care Nurs · Jan 2016
What Factors Are Associated With the Development of Pressure Ulcers in a Medical Intensive Care Unit?
Instruments used to determine the risk of pressure ulcer development are universally applied to adult patients. These instruments do not differentiate between intensive and acute care patients. ⋯ Vasopressor use and length of stay are not factors that are accounted for in current pressure ulcer risk assessment instruments. The administration of vasopressor support and patient length of stay are potential contributory factors that need to be considered when assessing patients. Instruments specific to intensive care unit pressure ulcer risk stratification are warranted and should include the unique characteristics of a critically ill patient.
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Background. Many older adults know about the health benefits of an active lifestyle, but, frequently, pain prevents them from engaging in physical activity. The majority of older adults experience pain, a complex experience that can vary across time and is shaped by sociocultural factors like gender. ⋯ Conclusions. Findings highlight that pain is significantly associated with physical activity in old age. The nature of this association depends on the time scale that is considered and differs between women and men.