Friday, 14 September 2018

To Change Nursing Practice with the new technologies

Exciting Technologies that are Changing Nursing Practice

The new technologies are affecting both Nursing and Healthcare. For patient records online and the use of other information technology software are the most obvious examples, but many other futuristic medical technologies straight out of science fiction are becoming a reality. Here’s a snapshot of some of the most exciting technological innovations and how they’re improving Nursing practice and patient outcomes.

Wi-Fi communique systems
Wireless badges or headsets integrate what were once a couple of communication methods — consisting of phones and pagers into one seamless technology, reducing response times. Wireless communication systems also can be “smart”: they are able to automatically route calls about certain situations or patients to specific nurses, or communicate with sensors and medical system to report patients’ fitness records.
These structures can also alert diverse healthcare specialists in case of emergencies as well as foster collaboration and communication in time-sensitive situations.

Real-Time location services
Nurses often must track down essential equipment, costing them time that would be spent on more pressing nursing duties or even slowing down response times during emergencies. A chip or code embedded in clinical equipment using indoor positioning systems can immediately locate the item. Such systems also can reduce down on theft or misuse, saving nursing departments cash on alternative or repair.
Real-time region services can also be used with patients who may suffer from mental illness or dementia through outfitting them with a wristband or badge embedded with the technology. Electronic borders can be created to set off an alarm while patients cross them — preventing them from wandering off and potentially injuring themselves or others. These services can also be integrated into nurses’ wireless communication systems to activate an emergency call button if their physical safety is threatened.

Wireless patient monitoring
Chips and sensors can be integrated into beds, blankets, and mattress pads to monitor and report on weight, blood pressure, movement, and more during sleep, serving as an extra layer of observation. This technology can help patients avoid bedsores and falls, and alerts nurses to any changes in patients’ fame, whether dramatic or slow building.

Clever TVs
As soon as just a tool for patient entertainment, TVs with smart technology can now offer records on upcoming treatments and deliver instructions for medication or post-discharge care. This facilitates patients become more educated and engaged with their health status and management. They can also use the smart TV to report pain levels and other signs, while the system can send non-clinical requests (along with orders for food or sparkling bedding) to an appropriate department or individual, maximizing the efficiency of nurses’ time and efforts.

Factor of Care era
Nurses and different healthcare experts may put on or carry technology that scans a barcode, which straight away sends important affected person data and medical history — such as a list of current medications, test results, and allergies — to a notebook or telephone, or maybe a wearable device such as Google Glass. Instead of having to pull information from several files, charts, and emails, nurses can immediately see lab results, reports from other healthcare specialists including psychiatrists or physical therapists, and past reactions to procedures or medicines, allowing them to quickly create or regulate a clinical care plan as wanted.

New innovations in technology can be as intimidating for nurses as it sometimes is for patients, so appropriate training and system design is vital for success. As technology is adapted into more health care settings, it may eventually be used in new, unexpected methods, or bring to mild new possibilities that can enhance nursing practice and health care even further.

Wednesday, 5 September 2018

To prevent Medication Errors in Nursing

Nurses, in particular, have the odds stacked against them due to the nature of the job. They manage multiple patients and multiple responsibilities on a daily basis, leaving very little room for other necessary duties. Nurses are also often fatigued and tired from working long or overnight shifts.
Ninety-seven percent of the nurses in the study identified fatigue due to high workload as the leading influencing factor of medication errors.

1. Ensure the five rights of medication administration are adhered to
Every time you administer a dose, it’s important to keep the five rights of medication in mind. This is one of the easiest ways to prevent medication errors in nursing and should be reviewed upon each administration of medication. These rights include:

The right patient: Are these medications prescribed to this patient and not the one next door and check names double times.

The right drug: Be sure the medicine you’re giving aligns with the doctor’s orders and patient treatment plan. If something doesn’t seem right — such as a drug you’ve never seen used for a specific diagnosis before — don’t be afraid to double check with the prescribing doctor.

The right dose: Double and triple check the dosage amount before administering.

The right route: Should pills be crushed or given whole to swallow and it Is the medication administered via IV or an NG tube and these details matter.

The right time: Be sure the medication is being given at the right scheduled time, whether morning, afternoon or evening. If it’s being given in intervals, such as every four hours, this should be recorded appropriately to avoid double dosing.

2. Pay close attention to drug packaging, labeling and nomenclature
According to Nurses Today, the packaging for many drugs looks similar. An adult nurse practitioner said that Healthcare organizations should ensure that all medications are provided in clearly labeled unit-dose packages for institutional use.
The manufacturer of heparin, Baxter Healthcare, has enhanced the labels on heparin packaging and other high-alert drugs, including a 20 percent larger font size, tear-off cautionary labels and different colors to distinguish dosage differences.

3. Double check — or even triple-check — individual patient procedures
This is one of the simplest ways to avoid medication errors in nursing. It usually involves having another nurse review all new medication orders to ensure that each patient’s medication is noted and transcribed correctly on the physician’s order and the medication administration record. Some hospitals may have similar procedures in place already, so be sure to follow those.
Paying close attention to high-alert medications in particular is important. A nurse should be independently double-checking themselves before administering them.

4. Put a zero in front of the decimal point
It sounds overly simplistic, but this simple action may help save a life. A dosage such as .25 mg can easily be misconstrued as 25 mg, which results in a potentially adverse outcome for the patient.

5. Document everything
Proper documentation includes: Proper medication labeling and legible documentation on charts or medication administration records.

A lack of proper documentation can result in an error. For example, if a nurse forgets to write down a dosage that was given for an as-needed medication, it can result in a second dosage being administered by another nurse because no record of the previous dose exists.
It’s a nurse’s job to put patients first, and preventing medication errors in nursing is important to patient success and improved overall health

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Wednesday, 29 August 2018

Innovations in Spontaneous Preterm Birth and Cervix

Spontaneous preterm birth (sPTB) is the main cause of neonatal deaths in the world. sPTB is poorly understood and multifactorial, involving main features such as infection/inflammation, bleeding, genetics, poor nutrition, social status, stress, ethnicity/race, and others.

The stages of sPTB dovetail into final unifying processes such as cervical remodeling. To finding that heterogeneous origins result in common downstream biological pathways and outcomes to provides the opportunity to develop rational treatment strategies that target the upstream initiators. In other words, if  identify cervical micro-structural changes prior to preterm birth, it would promote study and understanding of specific molecular events, which would in turn allow conceiving of novel approach to prediction, treatment and ultimately prevention of sPTB through identification of both imaging and molecular bio-markers.

The inverse relationship between a short cervix and preterm birth risk is establishing, and vaginal progesterone supplementation has emerges as a viable treatment. However, this treatment is imperfect; the risk reduction is modest (less than 50%) and the mechanism is unclear, making it difficult to choose the best candidates for the treatment. This is because most women with a short cervix in the mid trimester but no prior history of sPTB deliver at term without treatment, and most preterm births in low risk women occur in those with a normal mid trimester cervical length.

The immensely complex cervix is an investigator challenge. It has layers of collagen that remodel differently, likely because of independent molecular processes, and cause softening and shortening. Extensive micro-structural change has already occurred by the time shortening is evident; this means that cervical softening, which begins soon after conception and continues progressively throughout pregnancy, is likely more critical than shortening.

Many technologies are emerging to assess objectively the softness and microstructure of the pregnant cervix. In order to understand them, it is important to emphasize the central relationship between cervical softness and the organization and composition of the cervical extracellular matrix (ECM) because the pathogenesis of cervical softening and shortening likely relates to dysfunctional remodeling of the ECM. Approaches to evaluating ECM microstructure and softening of the pregnant cervix include elastography, acoustic attenuation, light-induced fluorescence, Raman spectroscopy, cervical consistency index, aspiration, quantitative ultrasound and shear wave speed estimation, among others. These are too numerous to cover in this, so the researchers focus on a few ultrasound-based techniques that have seen recent attention in the literature.

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Wednesday, 22 August 2018

Cardiovascular Nursing

Heart disease is the leading cause of death in the world. Every year, it is responsible for one in four deaths, killing more people than cancer. Taking care of the heart and the cardiovascular system should be a top priority for everyone—and the importance of heart health is not lost on the healthcare system.

The heart and the system supporting it is so important, it should be no surprise that there are healthcare professionals of all stripes who specialize in cardiology. Cardiac care nurses treat and care for patients with a variety of heart diseases or conditions.

Cardiac nurses are also called as cardiovascular nurses or cardiology nurses are registered nurses (RNs) who have specialized in the cardiovascular system. They work with patients who have heart problems according to their treatment plan a cardiologist assigns, monitoring patient progress and administering medication to help the healing process.

Responsibilities of cardiovascular Nursing:

Assessing and treating patients
Providing postoperative care
Monitoring stress test evaluations
Monitoring cardiac and vascular readings
Educating patients and their families
Supporting patient lifestyle changes
Cardiovascular Nurse Education

Cardiac nurses working in acute care scenarios might spend a lot of time around the defibrillator, for example—responding to patients in cardiac arrest. Cardiac nurses working in a surgical setting it will take lots of time to preparing patients for surgery and helping them recover afterwards.

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Monday, 13 August 2018

Bioresorbable stents: Cardiovascular Innovations

Interventional cardiology is made of great strides in the last few years. Percutaneous coronary intervention (PCI) is among the most commonly performed medical procedures. At the time of inception, PCI was plagued by high complication rates—balloon catheters had a 50% target-lesion restenosis rate at 6 months and required emergency bypass surgery in up to 6% patients.  With passage of time, the complication rate of PCI has markedly decreased.

The introduction of stents had a dramatic impact on lowering the complication rates. Initially, the bare-metal stents (BMS) reduced the stent restenosis rate to 10% to 15%. Drug-eluting stents (DES) has further revolutionized the field , significantly lowering rates of stent thrombosis (less than 0.5% in 1 year) and risk of restenosis (less than 5% in 1 year).3–6 The second-generation DES widely used in contemporary practice have made even more reductions owing to their improved designs and metallic and polymer composition; and concurrent advancements in the medical management, including use of antithrombotic and antiproliferative drugs, have further contributed to improved rates.

What, then, is to be hoped for further accordingly .Unfortunately, with the advent of stents, complications such as stent thrombosis and stent restenosis also emerged. These complications can be life-threatening in the form of post-procedural or late myocardial infarction and cardiac death. Thus, although the Food and Drug Administration (FDA) assesses target-lesion failure (defined as a composite of cardiac death, target vessel myocardial infarction, or ischemia-driven target vessel revascularization) at 1 year, patients can have complications for the remainder of their lives. Despite the advancements attained by the second-generation DES over their predecessors, the issue of stent thrombosis and restenosis continues to plague second-generation DES with a 2% to 2.5% increased rate of target-lesion failure each year, seemingly forever.

This will briefly discuss the stent design and pathophysiology driving stent thrombosis and restenosis along with potential strategies to mitigate the problem. It will pays special emphasis to bioresorbable stents, gives their increasing interest among interventional cardiologists and patients, and it will give their potential to transform the practice of PCI.

Sunday, 5 August 2018

Orthopaedic innovation

Orthopaedic and trauma care has always been subject to new ideas and approaches to care. Those who first saw the Thomas' Splint being used when someone was injured during the building of the Manchester Ship Canal in the late 1800s  would have been amazed by its simple design and potential to save both limb and life. Innovation does not, however, always begin in the places we would traditionally expect it to. Circular external fixator devices are still a relatively new innovation in the treatment of fractures, limb reconstruction and limb lengthening in most parts of the world. This is surprising given the relative simplicity of the idea that a frame made from circular rings, connected to rods and per cutaneous wires, can provide a much more stable frame and better bone healing and regeneration than other types of fixator. one of the Professor  had been experimenting with external fixation designs and distraction osteogenesis in Kurgan, Western Siberia since the 1950s, but it was only in the 1980s that it became known and was used elsewhere. The evidence of the benefits for this approach to skeletal stabilization and osteogenesis continues to increase but debate about its disadvantages also linger.

Innovation usually aims to make healthcare delivery more effective, more efficient, safer, cheaper or more sustainable, with benefits to patients through enhancement of life expectancy and improvement in quality of life. A well-known example of this in orthopaedic surgery is the total hip replacement (THR). Pioneered by one of the professor in the 1960s (although the development process was begun by other innovators decades earlier), the procedure is considered a major success in the improvement in quality of life for suffers of arthritis. THR is now one of the most commonly performed surgical procedures. Such product innovation is often driven by science and technology, through trial and error and through experimentation. Sometimes it is driven by industry's desire for profit and, often, by clinicians for the benefit of their craft, but mainly for the benefit of patients. A few weeks ago I heard about a new approach to THR which both surprised and delighted. we heard that it uses a relatively small incision and preserves the muscle and ligaments which provide stability to the hip joint. The surgery is performed without dislocating the joint. What seemed important  at the time was that this meant that patients could walk within a few hours of surgery  and that the ‘hip precautions’ we associate with caring for the patient following THR are deemed unnecessary because risk of dislocation is reduced. This significantly challenged any view that the journey commenced by professor had all but reached the end of the innovation road and that hip replacement surgery was likely to change little in the coming decades. This new approach, then, seems to have the potential to change the way post-operative care is provided, allowing patients to recover and go home even more quickly than they do already.

Monday, 30 July 2018

Palliative Care: Older Adults

Palliative care for elders are differs from what is usually appropriate in adults because of the nature and duration of chronic illness during old age. Care for the patient would include chemotherapy until it no longer meets the patient's goals of care; treating those symptoms (e.g., nausea, pain, fatigue); addressing her psychological and spiritual concerns; supporting her partner; and helping to arrange for care of children after them dead. The majority of the patient's care occurs at home (with or without hospice) or in the hospital, and the period of functional debility is brief (months). In reality, a frail 88-year-old widowed woman with advanced heart failure, diabetes mellitus, osteoarthritis, mild cognitive impairment, and frailty typifies the most common example of a patient requiring palliative care.


Palliative care for patient involves treating the primary disease process (advanced heart failure); managing her multiple chronic medical conditions and comorbidities (diabetes mellitus, arthritis) and geriatric syndromes (cognitive impairment, frailty), assessing and treating the physical and psychological symptom distress associated with all of the medical issues; and establishing goals of care and treatment plans in the setting of an unpredictable prognosis. Additionally, the needs of caregiver(s) are also different from those of the caregiver of the younger patient. Individual caring for geriatric patients are often adult children with their own families, work responsibilities, and medical conditions. The roles must be balanced with the months to years of personal care that they will provide to their aging parent. Lastly the older adults often make multiple transitions across care settings (home, hospital, rehabilitation, long-term care), especially in the last months of life, palliative care programs for older adults must know that care plans and patient goals are maintained from one setting to another.

Thus, palliative care for the elderly is centered on the identification and amelioration of functional and cognitive impairment; the development of frailty leading to dependence on caregivers; symptom, emotional, and spiritual distress; and bereavement needs of adult children and elderly partners.