Laparoscopic colectomy in octogenarians and nonagenarians: a preferable option to open surgery?

Objectives: To determine if laparoscopic colectomy is safer and more effective than open colectomy in patients older than 80 years of age.

Methods: An operating room database of all colectomies performed on patients >or=80 years, from January 2002 to September 2007, was analyzed retrospectively. Data reviewed included type of operation, type of resection, length of procedure, length of stay (LOS), estimated blood loss, American Society of Anesthesiologists (ASA) grade, diagnosis, complications, mortality rates, and discharge destination, with p-values <0.

Leading change.

Teamwork remains a big part of a rehabilitation unit's success. What do you do when there is dissension within the ranks and each shift becomes segregated, is resentful of the other, and spends a good part of each day complaining about the inadequacies of the current system? At one facility, patient falls, staff injuries, and workers' compensation cases were on the rise. Work became a chore that few looked forward to.

Online resources for pediatric home care clinicians.

Pediatric home care clinicians dealing with premature infants can encounter any number of unusual conditions related to their patient's prematurity. Finding reliable information on the condition can be difficult for a clinician who does not have immediate access to a health sciences library. There are, however, many useful, reliable websites that can be consulted with a laptop that has wireless access.

A call to action: mentoring within the nursing profession--a wonderful gift to give and share.

There is a great need for the use of mentors--professional mentors, peer mentors, faculty mentors, and student mentors--to expand the capacity for professional caregivers to meet the needs of a diverse society. Nurses need to become more proactive by taking part in mentoring within their own profession to promote successful leadership and professional development. The nursing profession is ever-evolving; however, its focus centers on the principle of human caring and this is most often related to patients.

Early postoperative complications following ostomy surgery: a review.

This article reviews early postoperative complications in adults undergoing ostomy surgery. Whether the ostomy is the result of an emergent or elective procedure, the WOC nurse and staff nurses are responsible for monitoring and ensuring quality healthcare for the patient. Nevertheless, many patients undergoing ostomy surgery experience a complication during the early postoperative period.

Da Vinci-assisted abdominal cerclage.

Objective: To report the first placement of an abdominal cervicoisthmic cerclage using the da Vinci robot.

Design: Case report.

Setting: Tertiary-care hospital.

The use of oral transmucosal fentanyl citrate during high-dose-rate gynecologic brachytherapy.

Gynecologic brachytherapy is a form of cancer treatment in which radioactive sources are placed into the pelvic organs via specialized applicators. Traditional low-dose-rate (LDR) brachytherapy has been performed over several days in a hospital setting. Since the 1990s, high-dose-rate (HDR) brachytherapy has been used increasingly because of its decreased treatment time, outpatient administration, and equal or superior efficacy compared with LDR treatment.

A randomized clinical trial of a videotape intervention for women with chemotherapy-induced alopecia: a gynecologic oncology group study.

Purpose/objectives: To evaluate changes in body image and self-esteem in women with gynecologic malignancies who experience chemotherapy-induced alopecia and to examine the effectiveness of a videotape intervention on body image and self-esteem.

Design: A prospective, randomized study.

Setting: Subjects were accrued from 11 Gynecologic Oncology Group (GOG) member institutions participating in 14 GOG treatment protocols.

Falls prevention, or "I think I can, I think I can": an ensemble approach to falls management.

Home care clinicians face a daunting challenge in attempting to prevent falls among the frail, elderly population. This article outlines how one agency used evidence-based strategies to develop a program that identified patients at risk for falls and intervened with the goal of decreasing injury from falls by using a multidisciplinary approach.

Alimentary tract surgery in the nonagenarian: elective vs. emergent operations.

The objective of this study was to compare elective with emergent surgery in patients over the age of 90 years. We retrospectively reviewed the records of patients over 90 years of age who underwent alimentary tract surgery between 1994 and 2002 at a community teaching hospital. Of 100 patients (mean age 92 years; range 90 to 98 years), 82 were women and 18 were men.

Polished automation tools allow patient safety to shine.

Follow the impact of computerized provider order entry on an acute care team.

Decreasing the incidence of falls in the nursing home in a cost-conscious environment: a pilot study.

Objective: To evaluate the prevalence of falls and determine the effectiveness of three simple interventions in decreasing the number of falls in a frail nursing home population.

Methods: Charts and records were reviewed to determine the prevalence of falls. Falls were tracked according to severity and time and place of occurrence.

How heart failure complicates care.

Review why heart failure (HF) develops and how it affects the nursing care of patients with other health problems.