A clinical trial to investigate the effect of silver nylon dressings on mediastinitis rates in postoperative cardiac sternotomy incisions.

Mediastinitis is a rare but serious postoperative complication of cardiac surgery that increases mortality rates, hospital length of stay, and medical costs. A clinical trial was conducted to investigate whether the type of postoperative surgical dressing (silver nylon or standard gauze) affects the rate of mediastinal infections. The sample consisted of 1,600 surgical cardiac patients.

An integrated model of group psychotherapy for patients with fibromyalgia.

This study examined the effectiveness of an integrated model of brief group psychotherapy for treatment of fibromyalgia syndrome, using cognitive behavioral and supportive expressive techniques. In the context of an outpatient, multidisciplinary fibromyalgia treatment program, group psychotherapy was provided to 35 patients with 21 control patients. Pre-post treatment measures of depression, anxiety, fibromyalgia impact, pain, fatigue, and morning tiredness were obtained.

Wound closure after split-thickness skin grafting is accelerated with the use of continuous direct anodal microcurrent applied to silver nylon wound contact dressings.

Wound healing after graft closure of excised burn wounds is a critical factor in the recovery process after thermal injury. Processes that speed time to stable wound closure should lead to improved outcomes, shorter lengths of hospital stays, and decreased complications. A randomized clinical trial to test the ability of continuous direct anodal microcurrent application to silver nylon wound contact dressings was designed.

Can't we all just get along? Know your role in fostering hospital-provider collaboration.

When nurses and physicians, both staff and management, work together toward mutually acceptable and productive goals, the patient and the institution prosper.

Changing the clinical management of hereditary hemochromatosis: translating screening and early case detection strategies into clinical practice.

Background: This article describes the effect of an extensive physician educational program on detection and management of hereditary hemochromatosis (HH) before and after a hemochromatosis population screening study.

Methods: We measured the changes in clinical management by medical chart review for newly diagnosed cases before and after the educational program. The effect on detection of HH cases was determined by mail survey to primary care physicians in our health system.

Could empathy be a predictor of hypnotic ability?

This study examined whether trait empathy is related to hypnotic ability and absorption. Sixty-four graduate students and mental health professionals completed the Harvard Group Scale of Hypnotic Susceptibility, Form A; the Davis Interpersonal Reactivity Index; and the Tellegen Absorption Scale as measures of hypnotic ability, empathy, and absorption. Correlation analysis determined that statistically significant relationships exist between empathy and hypnotic ability (r = .

Study habits and test-taking tips.

Everyone experiences test anxiety to some degree. Helpful suggestions about how to reduce test anxiety, how to study for tests, and how to develop good study habits can reduce this anxiety. Studying is different for different types of tests.

Development of a Code Blue Protocol test.

The purpose of this project was to develop a test to evaluate knowledge of the Code Blue Protocol at St. John's Regional Health Center. In critical care and telemetry units, the registered nurses are required to pass a yearly test concerning the Code Blue Protocol.

Detailed planning to upgrade the sterile-products preparation area to a cleanroom.

In a project to establish a cleanroom, the pharmacy manager is the person who must motivate everyone and keep the momentum going. Involving departments other than pharmacy is the key to success. The project provides an opportunity to improve the department's performance with the aid of other departments.

Decision tree. A process for determining when to withdraw or continue life-sustaining medical treatment.

Whether to provide life-sustaining treatment for never-competent adult patients or formerly competent patients whose wishes are unknown is one of the most difficult decisions healthcare providers face. To help address this problem, in 1992 the National Center for State Courts published Guidelines for State Court Decision Making in Life-sustaining Medical Treatment Cases. The publication contains a decision tree to help judges determine whether decisions to continue or discontinue life-sustaining treatment is within the law.

Common reactions to transfusions.

A blood transfusion is a special kind of transplantation, with the transfer of living tissue from one person to another. Reactions can occur with as little as 10 to 15 ml of incompatible blood. The onset of a reaction may be misleading or delayed, and its detection requires astute assessment.

Expansion of clinical pharmacy services through staff development.

A program that trains and uses staff pharmacists for clinical services is described. A position was created that is filled by staff pharmacists on six-week rotations. All full-time pharmacists may participate; they work under the direction and supervision of clinical pharmacists.

Procedural compliance and clinical outcome associated with therapeutic interchange of extended-spectrum penicillins.

The degree of procedural compliance and the clinical outcome associated with a therapeutic interchange of extended-spectrum penicillins were assessed. Pharmacists conducted a concurrent chart review on all patients receiving mezlocillin as a therapeutic alternative for piperacillin or ticarcillin over a five-month period. The pharmacists assessed whether (1) the pharmacy appropriately dispensed mezlocillin when orders were written for piperacillin or ticarcillin, (2) physicians and nurses were properly notified of the therapeutic interchange, and (3) the bacterial isolates were susceptible to mezlocillin.

Ciprofloxacin (intravenous/oral) versus ceftazidime in lower respiratory tract infections.

The efficacy and safety of intravenous ciprofloxacin was compared with intravenous ceftazidime in 80 hospitalized patients with lower respiratory tract infection. There were 40 patients in each treatment group. Patients and physicians were blinded to the randomized scheme for treatment groups until patient consent was obtained.