Using guided Imagery In cardiac sur...

Using guided Imagery In cardiac surgery

issues Management, July-September 2002

This quality improvement close attention examined surgical outcomes in sum of two units groups of patients undergoing cardiac surgery (1) Patients in the first cluster used guided imagery, and those in the inferior group did not. Preoperatively, patients in the first clump were educated about guided imagery and its possible benefits. They received sum of two units audiotapes with instructions to listen to them several times by day. On the day of surgery patients in the first arrange were encouraged to listen to their tapes before and from end to end induction of anesthesia and after surgery During the initial recuperation period, they were encouraged to listen to their tapes to forward sleep and alleviate anxiety or pain during hospitalization. They also were encouraged to listen to the tapes for the first week or sum of two units after discharge.

Findings. Researchers set up that patients who completed the guided imagery program had an common and one-half day shorter average detail of stay, a decrease in average direct pharmacy take away froms and a decrease in average direct pain medication preciousnesss compared to the patients who did not use guided imagery. They also reported high overall patient satisfaction with the care and treatment provided.

Clinical implications. Guided imagery should be considered a complementary mode of reducing anxiety, pain, and continuance of stay for patients undergoing cardiac surgery and should be exhibited to patients interested in its use. Use of audiotapes is a cost-effective intervention that requires little time or effort upon the part of clinicians. In this investigation the cost of care was lower and the long duration of stay was shorter for patients who used guided imagery. Furthermore, the use of guided imagery and other complementary therapies should be evaluated in other surgical populations and clinical settings.

Preoperative smoking intervention decreases postoperative complications

Lancet, Jan 12 2002

This randomized clinical trial examined 120 patients who were daily smoker scheduled for primary elective hip or knee replacement. (2) Six to eight weeks before surgery 60 participants were provided a smoking intervention that included a weekly meeting, a personalized nicotine substitution schedule, and nicotine substitution returnss They also were given advice about smoking cessation or reduction, information about benefits of cessation, and information about management of withdrawal symptoms. The other 60 patients received usual care consisting of little or no advice or counseling about smoking cessation.

Findings. Rates of postoperative complications were a great deal of lower in the smoking intervention arrange compared to the usual care clump The greatest reductions were in wound-related and cardio-vascular complications.

Clinical implications. Patients undergoing elective surgery should be encouraged to cease or bring tobacco consumption. Nurses play an important part in providing patients with advice and counseling about smoking cessation and should provide patients with appropriate resources preoperatively.

Hospital pagers and bacteria

Infection regulate and Hospital Epidemiology, May 2002

This prospective, cross-sectional analysis examined the bacterial contamination of the pagers of health care personnel and the effectiveness of disinfection with 70% isopropyl alcohol in a 511-bed community teaching hospital. (3) Participants included a convenience sample of 100 health care workers, including staff members, attending physicians, RN respiratory therapists, and medical scholars who provide direct patient care. agricultures from pagers were collected and plated in a standardized manner.

Findings. cultivations revealed coagulase-negative staphylococci and Staphylococcus aureus upon pagers from all health care worker clusters Other microorganisms isolated in agricultures included Bacillus species, Micrococcus species, Streptococcus species (nongroup A), aerobic diphtheroids, Candida species, and aerial mycelia. tillages of three pagers revealed methicillin-resistant Staphylococcus aureus (MRSA). Disinfecting the pager surface with an isopropyl alcohol swab reduc the total colony reckon by 94%. Of further interest is that 88 of the 100 participants had not ever cleaned their pagers.

Clinical implications. From this consideration it is apparent that clinicians who carry pagers should clean them onward a routine basis. Obviously, if a clinician touches a pager during a patient examination or when conducting a operation the pager should be cleaned afterward. The use of 70% isopropyl alcohol significantly decreases bacterial load and pathogenic bacteria. It is unclear whether pagers could benefit as vectors of nosocomial infection, still health care workers must consider that potential when touching or handling a pager.

Can scissors transmit nosocomial Infection

Infection repress and Hospital Epidemiology, March 2002

Researchers in this point-prevalence contemplate examined 232 pairs of scissors belonging to health care workers in all medical, surgical, and pediatric wards, including difficulty departments and intensive care units, in couple tertiary care university-affiliated hospitals. (4) refinement swabs were collected and plated in a uniform manner. After the swabs were gathered the scissors were cleaned with an individually wrapped 70% alcohol swab and responded to the owners. Subsequently, scissors were rareed randomly and reswabbed for cultures