Adherence to Best Practice Advice for Diagnosis of Pulmonary Embolism.

Purpose: This study evaluated clinician adherence to the American College of Physicians Best Practice Advice for diagnosis of pulmonary embolism.

Design: A prospective, single-center, descriptive design was utilized.

Methods: A heterogeneous sample of 111 hemodynamically stable adult inpatients with a computed tomography pulmonary angiogram ordered was consented.

Foot Health Assessment and Problem Identification in a Dominican Batey Community: A Descriptive Study.

Purpose: Foot problems can adversely impact foot function and quality of life. Foot problems are often overlooked, particularly in populations with limited health care access. Little is known about the foot health of Haitian immigrants who live and work in the bateyes (rural sugarcane villages) of the Dominican Republic.

Foot Care Self-Management in Non-Diabetic Older Adults: A Pilot Controlled Trial.

Self-management can mitigate common foot problems; however, community-dwelling older adults without diabetes rarely receive foot care self-management training. This two-group pilot study examined feasibility and preliminary efficacy of the novel, nurse-led 2 Feet 4 Life intervention. Twenty-nine adults ( age 76 years ± 6.

Excluding Pulmonary Embolism with End-tidal Carbon Dioxide: Accuracy, Cost, and Harm Avoidance.

A non-randomized single center prospective, descriptive, correlational design was used to determine what end-tidal carbon dioxide (EtCO) level provided the best sensitivity, specificity, and negative predictive value to exclude pulmonary embolism (PE) diagnosis in hemodynamically stable hospitalized adults ( = 111). The financial impact and harm avoidance of adding EtCO to the PE diagnostic process also were examined. PE diagnosis was determined by computed tomography pulmonary angiography (CTPA).

Diagnosis of pulmonary embolism: Following the evidence from suspicion to certainty.

Accurate, timely and cost-effective identification of pulmonary embolism remains a diagnostic challenge. This article reviews the pulmonary embolism diagnostic process with a focus on the best practice advice from the American College of Physicians. Benefits and risks of each diagnostic step are discussed.

Analysis of qualitative interviews about the impact of information technology on pressure ulcer prevention programs: implications for the wound, ostomy and continence nurse.

Purpose: The purpose of this study was to compare pressure ulcer prevention programs in 2 long-term care (LTC) facilities with diverse Information Technology Sophistication (ITS), one with high sophistication and one with low sophistication, and to identify implications for the WOC nurse.

Design: Secondary analysis of narrative data obtained from a mixed-methods study.

Subjects And Setting: The study setting was 2 LTC facilities in the Midwestern United States.

The effect of clinically relevant pressure duration on sacral skin blood flow and temperature in patients after acute spinal cord injury.

Objective: To test the effect of clinically relevant duration of pressure loading (2 h) on sacral skin blood flow (SBF) and skin temperature in subjects with spinal cord injury (SCI) within 24 to 96 hours after injury compared with subjects with acute orthopedic trauma and healthy subjects.

Design: Three-group, repeated-measures, inception cohort.

Setting: Three acute care hospitals in southern Thailand.

Impact of the Health Insurance Portability and Accountability Act on participant recruitment and retention.

Recruiting and retaining an adequate sample is critical to the success of any research project involving humans. Recent reports indicate that the Health Insurance Portability and Accountability Act (HIPAA) privacy rule has adversely affected research. Few resources are available to help researchers navigate the challenges to recruitment and retention after HIPAA privacy rule implementation.

Effect of oral hydration on skin microcirculation in healthy young and midlife and older adults.

Clinically undetected underhydration lowers subcutaneous tissue oxygen, impairs healing and increases wound infection. This study examined the effect of supplemental oral hydration on noninvasive measures of skin temperature (T(s)), transcutaneous skin O(2) (PtcO(2)), and CO(2) (PtcCO(2)), and skin blood flow (laser Doppler fluxmetry [Flux]=concentration of moving blood cells [CMBC] x Velocity) in healthy adults. Nineteen Control and 18 Test (Hydrated) subjects participated.

Impact of pain on outcomes in long-term care residents with and without multiple sclerosis.

Objectives: To compare long-term care (LTC) residents with and without multiple sclerosis (MS); to compare admission status of pain, physical disability, pressure ulcers, depression, and cognitive performance in LTC residents with and without MS; and to examine the impact of MS and pain on outcomes 90 and 180 days after LTC admission.

Design: Retrospective analysis of a large data set.

Setting: LTC facilities in Missouri.

Elevated sacral skin temperature (T(s)): a risk factor for pressure ulcer development in hospitalized neurologically impaired Thai patients.

Pressure ulcer incidence and sacral skin temperature (T(s)) were measured in hospitalized neurologically impaired Thai patients ( n = 17) positioned supine and then laterally. Pressure ulcer incidence within 2 weeks of admission was 47%. Regardless of reclining position, mean sacral T(s) in subjects who developed a pressure ulcer was higher ( p < .

Nursing home quality and pressure ulcer prevention and management practices.

Objectives: To measure pressure ulcer quality indicator (QI) scores and to describe the self-reported skin integrity assessment, pressure ulcer risk assessment, and pressure ulcer prevention and treatment practices in long-term care facilities (LTCFs).

Design: Retrospective analysis of a large data set and comparative survey.

Setting: LTCFs in Missouri.

Skin assessment and pressure ulcer care in hospital-based skilled nursing facilities.

The Minimum Data Set, a comprehensive assessment tool for nursing home residents, is used for clinical decision-making, research, quality improvement, and Medicare and Medicaid reimbursement. Within the Minimum Data Set, pressure ulcers and skin condition are evaluated. Because information about pressure ulcer prevalence and care in hospital-based skilled nursing facilities is sparse, a study was conducted to: a) determine pressure ulcer prevalence upon admission to hospital-based skilled nursing facilities in the state of Missouri, and b) ascertain methods of assessment, treatment, and documentation of skin and pressure ulcer care in these facilities.

Why older adults with light care needs enter and remain in nursing homes.

Many patients in nursing homes receive limited services. In 1996, approximately 17% of the 1.6 million nursing home residents received assistance with two or less activities of daily living (ADL).