Healthcare

Routine asthma review
Asthma is the most common chronic condition seen in primary care and creates a significant work load in both primary and secondary care. Mortality and morbidity remain unacceptably high as the majority of both are avoidable with optimal use of preventative medicines. It is not only good practice to regularly review every patient with a long-term condition, but when coupled with self-management ...


Improving Sepsis Management in the Acute Admissions Unit
Sepsis is a common condition with a major impact on healthcare resources and expenditure. We therefore wanted to investigate and improve how the acute admission unit (AAU) at the Great Western Hospital (GWH) is managing patients who present directly to the unit with sepsis. In order to obtain this information, an audit was undertaken against the College of Emergency Medicine standards used by t...
A Historical Perspective of the Effect of the Great Recession on Hospitals
At 18 months, the Great Recession of December 2007 to June 2009 is the longest recession since World War II. The recession led to soaring unemployment, resulting in loss of employment-based health insurance for millions of people. In addition to seeing increases in uninsured patients, hospitals experienced losses in their investment portfolios, which in turn increased bad debt, charity care, an...


Safety and Usability of Hemostats, Sealants, and Adhesives
Hemostats, sealants, and adhesives are an integral part of surgical patient care. Nurses who have knowledge about these agents can better help ensure safe, efficient surgical patient care. As a caregiver and patient advocate, the perioperative nurse must understand the most current information about these agents and be prepared to facilitate the transfer of this knowledge to all caregivers. Inf...
How Hemostatic Agents Interact With the Coagulation Cascade
Hemostasis is a critical component of the preservation of hemodynamic stability and operative visibility during surgery. Initially, hemostasis is achieved via the careful application of direct pressure to allow time for the coagulation cascade to create a fibrin and platelet plug. Other first-line methods of hemostasis in surgery include repair or ligation of the bleeding vessel with sutures, c...


Hemostatic Agents: A Guide to Safe Practice for Perioperative Nurses
Perioperative hemostasis, the effective management of bleeding during operative and other invasive procedures, can involve the use of blood, blood products, and hemostatic agents to augment the patient’s natural clotting abilities. Currently, more than 50 hemostatic products are available in the marketplace and dozens more are in development. It is important for perioperative nurses to unders...
Caudal Blockade for Children Undergoing Infra-abdominal Surgery
The assessment and management of pain in children can be complicated by their inability to communicate effectively; therefore, it is important that every attempt be made to circumvent the undertreatment of pain. Caudal blockade is associated with excellent pain relief and minimal side effects, and it is an established technique used in conjunction with general anesthesia for children undergoing...

Back to Basics: Positioning the Patient
Positioning the surgical patient requires special attention from the entire surgical team because anesthetized or sedated patients are not able to reposition themselves when needed to relieve discomfort or alert team members of the need for repositioning. Perioperative nurses must pay attention to positioning details and the possibility of injury at all times during the patient’s procedure. T...
Implementing AORN Recommended Practices for a Safe Environment of Care, Part II
Construction in and around a working perioperative suite is a challenge beyond merely managing traffic patterns and maintaining the sterile field. The AORN “Recommended practices for a safe environment of care, part II” provides guidance on building design; movement of patients, personnel, supplies, and equipment; environmental controls; safety and security; and control of noise and distrac...

Endovascular Aortoiliac Aneurysm Repair: Surgical Progress Through New Treatment Paradigms and Innovative Endograft Design
Effective treatment for patients with an abdominal aortic aneurysm (AAA) began more than 50 years ago through the development of prosthetic grafts, which were used to replace aneurysmal segments of diseased arteries. Open surgical repair of AAAs became the gold standard for treating this disease. In 1999, two device manufacturers received US Food and Drug Administration approval for their endov...
Management Considerations for Implementing an Endovascular Hybrid OR
A hybrid procedure is the use of procedural techniques from different specialties to accomplish a shared procedural goal. Hybrid interventional suites combine the capabilities of an OR with the technologies of interventional radiology, thereby offering a modern solution to the care of patients with complex vascular pathology by using the least-invasive procedure possible. Management considerati...

Treatment of Abdominal Aortic Aneurysms: The Role of Endovascular Repair
Rupture of an abdominal aortic aneurysm (AAA) is a significant cause of mortality in the United States. Often asymptomatic, AAA is considered a silent killer because it frequently remains undiagnosed until the time of rupture or the patient’s death. Major risk factors, such as smoking, age, sex, race, and family history of aortic aneurysm, affect the formation of AAAs. National screening reco...
The paediatric psychiatric emergency population in a university teaching hospital in Belgium (2003–2008)
In the last few decades, there has been a remarkable increase in the number of children and adolescents presenting with psychiatric complaints to the emergency department in the USA. In Europe, however, less is known about the paediatric psychiatric emergency population. This study provides a clinical and demographic profile of this population and its service use in a European context. From 200...
Acute complications and outcomes of acute head injury in adult patients with haemophilia
The aim of the present study is to describe the clinical and epidemiological characteristics, complications and outcome of patients with haemophilia and acute head injury (AHI) at the emergency department (ED), and develop a protocol to prevent early and late complications. This is a retrospective cohort study including all patients with haemophilia and AHI admitted to the ED. We identified 26 ...
Rhythm recognition is accountable for the majority of hands-off time during cardiopulmonary resuscitation – a simulation study
Cardiopulmonary resuscitation guidelines are constantly optimized to increase survival. Keeping hands-off time brief is vital. Our hypothesis is that rhythm recognition is time-consuming during cardiopulmonary resuscitation. A Laerdal Sim-Man simulated three shockable and four nonshockable rhythms. Rhythms were presented to physicians who identified whether they were shockable and whether they ...