bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Associated with a Perceived Harmful Outcome from Medication Errors: A Pilot Study
Authors: Wolf Zane Robinson , McGoldrick Terry B , Flynn Elaine R , Warwick Frances 
Published: April 2021

ABSTRACT
The purpose of this pilot study was: 1) to describe factors associated with a perceived harmful outcome following medication errors made by nurses and 2) to refine the Medication Error Risk Profile (MERP) (Wolf, 1992). Ninety-four registered nurses and licensed practical nurses completed the MERP. Multiple stepwise regression analyses were used to explain the variance in the dependent variable of perceived patient harm with: 1) phases of preparation and administration; 2) categories of person responsible for the error; 3) interventions needed following the error and symptoms related to the error. The exploratory regression analysis suggests a model in which the dispensing phase of administration, the physician and pharmacist categories of persons responsible for the error, and the interventions of patient transfer to another unit and additional medications given following the error explain 53% of the variance in perceived harmful outcome for patients consequent to medication errors. A moderately strong correlation (r=.46, P<.001) existed between perceived patient harm as measured on the four-point scale and total intervention score following medication errors.
Nonpharmacologic Interventions to Manage Children's Pain: Immediate and Short-Term Effects of a Continuing Education Program
Authors: Pederson Carol 
Published: April 2021

ABSTRACT
A two-group pretest, posttest design was used to test the effects of a two-hour educational program about using five nonpharmacologic pain management techniques with children on nurses' knowledge of, comfort with, attitude toward, and use of the discussed techniques. Five pediatric patient care units were randomly assigned to a treatment or control group. Pretest responses from 54 nurses indicated that attitude was the only significant determinant of their intention to guide children's imagery. A subset of 35 nurses actually attended the program and completed posttest responses. On posttest, the treatment group reported significantly greater knowledge of and comfort with using the techniques. Comparison of pretest with posttest responses across both groups indicated a significant increase in knowledge of and comfort with using nonpharmacologic techniques. Two months after the program, 24 nurses from both groups reported increased use of the techniques in practice compared with prior to the program.
The Case Against Mandatory Continuing Education
Authors: Hewlett Peggy O'Neill , Eichelberger Lisa Wright 
Published: April 2021

ABSTRACT
Requiring continuing education (CE) for RN relicensure began in the 1970s and has remained a controversial issue over the past 25 years. This article is a description of the process used by nurses in one state to investigate the complex issues surrounding mandatory continuing education for relicensure and the factors that led state nursing leaders to support the continuation of a voluntary CE system. Included are the findings of a survey of all states currently requiring continuing education for relicensure. The primary reason given for mandating CE was to protect the public, however, no data are available to support this premise.
Planning Continuing Nursing Education: An Interview with Ronald M. Cervero
Authors: Waddell Donna L 
Published: April 2021

ABSTRACT
This article reports an interview with Ronald M. Cervero, scholar in the field of continuing professional education and co-author with Arthur L. Wilson of Planning Responsibly for Adult Education: A Guide for Negotiating Power and Interests (1994). The substance of the interview elucidates the role of the manager of the continuing nursing educational experience. He discusses the concepts of negotiation, power, interests, and responsibility and how they impact the planning of continuing nursing education.
21 Predictions for the Future of Hospital Staff Development
Authors: Nowicki Cynthia R 
Published: April 2021

ABSTRACT
No one knows for sure how the future will look. However, there is no better time than today to begin envisioning and creating our preferred future. This article discusses several factors that will impact the future of nursing staff development. Twenty-one predictions are offered that include: change, restructuring, teamwork, leadership development, paradigms, support networks, staff development roles, learning, value of life experiences, patient education, cultural diversity, and technology. Strategies for educators to position themselves for the future are suggested. The future is ours to create. The intent of this manuscript is to challenge staff development educators to create visions and develop strategies to construct the preferred future of their roles and the nursing staff development function.
Computer-Assisted Instruction for Home Study: A New Venture for Continuing Education Programs in Nursing
Authors: Neafsey Patricia J 
Published: April 2021

ABSTRACT
Background: Advanced practice nurses (APNs) tested a 5-contact hour home-study computer assisted instructional (CAI) program in pharmacokinetics developed by the author.
Method: Twenty-seven APNs enrolled in a traditional lecture continuing education course in pharmacology participated in the study. The APNs were given a knowledge test and self-efficacy questionnaire before using the CAI program and again at the completion of program use.
Results: Significant gains in knowledge and self-efficacy with large effect sizes were achieved by the program users. They cited the convenience, organization and simplicity of use, graphic animations, and interactive question sequences as advantages of the program.
Conclusion: Home study by computer may be a feasible option to printed home-study and lecture-based continuing education programs in nursing.
Application of the Critical Pathway and Integrated Case Teaching Method to Nursing Orientation
Authors: Goodman Deborah 
Published: April 2021

ABSTRACT
Background: Nursing staff development programs must be responsive to current changes in healthcare. New nursing staff must be prepared to manage continuous change and to function competently in clinical practice.
Method: The orientation pathway, based on a case management model, is used as a structure for the orientation phase of staff development. The integrated case is incorporated as a teaching strategy in orientation. The integrated case method is based on discussion and analysis of patient situations with emphasis on role modeling and integration of theory and skill.
Results: The orientation pathway and integrated case teaching method provide a useful framework for orientation of new staff. Educators, preceptors and orientees find the structure provided by the orientation pathway very useful.
Conclusion: Orientation that is developed, implemented and evaluated based on a case management model with the use of an orientation pathway and incorporation of an integrated case teaching method provides a standardized structure for orientation of new staff. This approach is designed for the adult learner, promotes conceptual reasoning, and encourages the social and contextual basis for continued learning.
Bathroom Blitz It!
Authors: Simmons Pamela B , Launius Beatrice 
Published: April 2021

ABSTRACT
Background: Staff development specialists are always looking for new and better ways to get the JCAHO message to their organization's staff.
Method: The staff development department used a novel method, the Bathroom Blitz, to educate captive audiences, one-person-at-a-time, thereby using the common situation in an uncommon way.
Results: Twelve hundred employees had the opportunity to regularly become informed of JCAHO topics without having to leave the unit.
Conclusion: The Bathroom Blitz approach was an effective tool for educating staff in preparation for the many "mock surveys" conducted prior to Joint Commission and the actual onsite JCAHO visit.
Nursing Education and Nursing Research Utilization: Is There a Connection in Clinical Settings?
Authors: Brown Diane Storer 
Published: April 2021

ABSTRACT
According to a survey of 753 nurses in Northern California, nurses with higher levels of education are more involved in research utilization and research activities. The data support the American Nurses' Association model of progressive involvement in research utilization and research conduct. Recommendations to improve research utilization in clinical and academic settings are provided.
Original Technique for Noninvasive Electric Stimulation Designed for the Hoffmann® Fixator
Authors: Jørgensen T Ejsing 
Published: April 2021

ABSTRACT: The standard Hoffmann fixator is ideal for electrical stimulation, using the pins as electrodes and the frame for fixation of the fracture and the stimulator. The main problem in this method of stimulation is the corrosion of the pins, which are made of stainless steel. Through 12 years of clinical research on human fractures, an electronic stimulator has been developed that eliminates the pin corrosion problem. The stimulator delivers an asymmetrical pulsating voltage with voltage- and current limitation, automatic pole reversing, patient control, and a continuous working time of six to nine months.
Animal experiments have shown increased growth of blood vessels in osteotomies and activation of periosteal callus, using this means of stimulation. Experiments in humans have revealed 30% faster healing in fresh lower leg fractures, increasing difference of skin temperature between stimulated and nonstimulated bones, and increased uptake of labeled technetium of the whole bone when stimulated. Encouraging clinical results have been obtained in treatment of slow unions, pseudarthroses, and failed arthrodesis.
Study of the Mechanical Characteristics of External Fixation Pin Anchorage: Preliminary Results
Authors: Wagenknecht M , Andrianne Y , Burny E , Donkerwolcke M 
Published: April 2021

ABSTRACT: in vitro testing of pins only makes sense if it is carried out on a material that possesses mechanical characteristics coresponding most closely to those of the bone in vivo. Tests have been carried out on different materials, including wood with 3 mm diameter pins, type C38-1 10-20, manufactured by Jaquet Orthopedic SA.
The first step in our investigation was to check the thickness of the material samples tested. The values of the tapping, screwing and shearing torques were measured. For each material, we have calculated the value of the specific screwing torque and the specific shearing torque. There is no significant difference between the values calculated for the tightening and shear specific torques for all the fresh bone samples. For the different types of wood examined, we found an important deviation of torque values, which are much lower than those observed with fresh bone. There exists, therefore, a correlation between the screwing and shearing torques observed and the thickness of the sample. The results obtained certainly allow new types of pins to be developed.
External Fixation of the Fracture of the Humerus: A Review of 164 Cases
Authors: Hinsenkamp M , Burny F , Andrianne Y , Quintin J , Rasquin C , Donkerwolcke M , Picchio A A , Asche G 
Published: April 2021

ABSTRACT: During our experience with external fixation for the fractures of the shaft of the humerus since 1967, the indications have been extended to include complex metaphyseal and epiphyseal fractures of both the proximal and the distal part of the bone. We propose elastic fixation of the fragments using half frame Hoffmann external fixation. Because of anatomical considerations, the two proximal pins must be inserted laterally in the upper third of the humerus, and the two distal pins in the posterior aspect of the lower third above the olecranon fossa. If the mechanical properties of the bone are poor (due to osteoporosis) more than two pins must be used in each fragment. The advantages of the technique include fast and easy application requiring simple materials; versatility of use for fractures at different levels; possible closed reduction, as in conservative treatments; early rehabilitation of joint function; fast periosteal callus formation; and retrieval of the fixator on an outpatient basis.
The reduction and the immobilization of the fracture by osteotaxis are done in emergency. Closed reduction is performed as in conservative treatments. In cases of important muscular interposition, open reduction is possible. Associated internal fixation was required in 18.4% (unstable or articular fractures). A secondary transient radial palsy is observed in 5% of the patients. Intolerance to the external fixation appears in 5.6% of cases, usually consisting of drain age and redness around the pin tracts. A general evaluation of the results gives 73.8% very good results and 93.6% satisfactory results after rehabilitation.
Peripheral Nerve Compression: Etiology, Critical Pressure Threshold, and Clinical Assessment
Authors: Szabo Robert M , Gelberman Richard H 
Published: April 2021

ABSTRACT: A number of experimental studies in our laboratory have been designed to evaluate the functional response of the median nerve at the wrist to various degrees of acute local compression in healthy volunteers and hypertensive patients. The relative significance of ischemia and mechanical deformation in early nerve compression, the critical threshold pressure for nerve conduction impairment, and the clinical sensibility testing system most accurate for evaluating and following patients with acute and chronic compressive neuropathies have been determined using a human model for median nerve compression in the carpal tunnel.
Between 40 mmHg and 50 mmHg there exists a critical threshold pressure in normotensive people at which peripheral nerve is acutely jeopardized. The critical pressure threshold is higher in hypertensive patients. The threshold exists at 30 mmHg below diastolic blood pressure and 45 mmHg below mean arterial blood pressure in both normotensive and hypertensive individuals. The correlation between systemic blood pressure and the function of the nerve in response to local compression favors the concept that reduced microvascular perfusion plays the major role in the early stages of low pressure nerve compression. In acute and chronic compression neuropathy, threshold tests (Semmes-Weinstein pressure, vibratory sensibility) detect the earliest abnormalities of nerve function.
INTEGRATING COMPUTERS INTO ORTHOPEDIC RESEARCH
Authors: Aguilar Erwin A , Baratta Richard V , D'Ambrosia Robert 
Published: April 2021

ABSTRACT
The role of computers in orthopedic research and education is expanding rapidly. Its potential to manipulate large amounts of data and execute multiple complex assignments with great speed and accuracy indeed make the computer an awe-inspiring device. An important instrument in research is the computerized database, a collection of related data arranged so that useful information may be retrieved. Computer models derived from classical physics and fluid mechanics have been used to study motion of both extremities and spinal articulations. Computers also have found usefulness in clinical orthopedic research. The orthopedist of the future will use the computer directly in clinics and private practice for patient evaluation, computerassisted preoperative planning, and financial recordkeeping.
BENT PLATE FIXATION IN COMBINED INTERTROCHANTERIC AND SUBTROCHANTERIC FRACTURES OF THE FEMUR
Authors: Rowe Sung Man , Chung Jae Yoon , Moon Eun Sun , Song Eun Kyoo 
Published: April 2021

ABSTRACT
Twenty-five combined intertrochanteric and subtrochanteric fractures of the femur (Type IV of Kyle's or Type V of Seinsheimer's classification) were treated with a bent plate and followed up through union (average: 2 years). All of the patients received immediate supplementary bone grafting and additional external supports. AU but one of the fractures united between 3 and 6 months. Complications were: delayed union (1 case), which was treated by bone graft, trochanteric bursitis (3), and mild coxa vara (2). Anatomical reduction of scattered fragments and its maintenance through bony union were achieved in all cases. The bent plate provided excellent fixation in combined intertrochanteric and subtrochanteric fracture of the femur, and could be a successful alternative for these combined fractures.
POLIOENCEPHALITIS, STRESS, AND THE ETIOLOGY OF POST-POLIO SEQUELAE
Authors: Bruno Richard L , Frick Nancy M , Cohen Jesse 
Published: April 2021

ABSTRACT
Post-mortem neurohistopathologies that document polio virus-induced lesions in reticular formation and hypothalamic, thalamic, peptidergic, and monoaminergic neurons in the brain are reviewed from 158 individuals who contracted polio before 1950. This polio-encephalitis was found to occur in every case of poliomyelitis, even those without evidence of damage to spinal motor neurons. These findings, in combination with data from the 1990 National Post-Polio Survey and new magnetic resonance imaging studies documenting post-encephalitis-like lesions in the brains of polio survivors, are used to present two hypotheses: 1) polioencephalitic damage to aging reticular activating system and monoaminergic neurons is responsible for post-polio fatigue, and 2) polioencephalitic damage to enkephalin-producing neurons is responsible for hypersensitivity to pain in polio survivors. In addition, the antimetabolic action of glucocorticoids on poliodamaged, metabolically vulnerable neurons may be responsible for the fatigue and muscle weakness reported by polio survivors during emotional stress.
A RAT MODEL OF THE POST-POLIO MOTOR UNIT
Authors: Pachter Bruce R , Eberstein Arthur 
Published: April 2021

ABSTRACT
We examined the long-term effects of muscle usage on a rat model of the post-polio motor unit. Isometric tensions, type I and type II muscle fiber areas, the incidence of collateral sprouting, and motor enripíate morphology were examined following I1 3, 6, and 9 months of partial denervation in rat plantaris muscle. Full morphologic and functional stability of the expanded motor units occurred at 6 months post-partial denervation. Fiber hypertrophy was observed, possibly the result of compensatory work hypertrophy due to muscle overuse. Following 9 months of partial denervation and muscle overuse, the twitch and tetanic tensions and type I and type ? muscle fiber areas were significantly reduced as compared to sham controls; anguIated myofibers and group atrophy also were seen. The percent collateral sprouting, the number of terminal branches per endplate, and the endplate area were all increased, possibly a compensatory response to a decreased synthesis of neurotrophic factor(s) and/or transmitter-related components. These aging-like changes seem to occur earlier in chronically stressed, overenlarged, and overworked motor units.
AUTOGENOUS BONE GRAFTS: NONVASCULAR AND VASCULAR
Authors: Springfield Dempsey S 
Published: April 2021

ABSTRACT
Nonvascularized autogenous bone grafts have been used for at least 150 years. Vascularized bone grafts were first done only 17 years ago. We now know that bone grafts act through osteoconductive and osteoinductive mechanisms to produce new bone. Autogenous bone grafts remain the gold standard against which allografts and artificial graft materials should be measured.
DISTAL FEMORAL OSTEOTOMY FOR VALGUS DEFORMITY OF THE KNEE
Authors: Terry Glenn C , Cimino Peter M 
Published: April 2021

ABSTRACT
Distal femoral varus osteotomy and bladeplate fixation for valgus deformity of the knee proved effective in restoring axial alignment in 18 of 36 knees (34 patients). Patients were followed for an average of 5.4 years (range: 2 to 19 years). The osteotomies were performed on 14 men and 22 women (average age: 44 years; range: 14 to 77). The patients' average preoperative valgus deformity of the anatomical axis was 19.4° (range: 8° to 33°). The surgical procedures performed were a medial closing wedge osteotomy (14 knees) and a lateral opening wedge osteotomy with bone grafting (22 knees). Postoperative correction of the anatomical axis averaged 3.8° valgus (range: 8° varus to 20° valgus). Maximum improvement was reached within 6.3 months by patients who were less than 60 years old and within 5.1 months by patients who were more than 60 years old. Pain decreased or resolved in 21 of 35 knees (60%); activity level improved in 24 of 35 knees (69%). One patient was unavailable for follow up evaluation. Varus osteotomy in the distal femur was concluded to be an acceptable form of treatment in the valgus knee alone or associated with traumatic or osteoarthritis of the lateral compartment.
PHILOSOPHY OF OSTEOSYNTHESIS IN SHOULDER FRACTURES
Authors: Fleischmann W , Kinzl L 
Published: April 2021

ABSTRACT
A wide range of workable instrumentation is available for the treatment of proximal humeral fractures, whereas osteosynthesis of scapular fractures is commonly achieved by plate/screw fixation. Older persons are confronted with a steadily rising incidence of osteoporotic fractures. Especially for this group of patients, minimally invasive and minimally instrumented surgical procedures, such as K-wiring and bone sutures, seem to have superseded plate fixation. For the treatment of scapular fractures, an important question remains: Which fracture types provide better functional results with open reduction and internal fixation, and which with conservative treatment? Our indications for an operative procedure are limited to the floating shoulder, dislocated scapular neck fracture, and dislocated glenoid fracture.
SPINAL INJURIES IN 57 PATIENTS 17 YEARS OR YOUNGER
Authors: Mann David C , Dodds Julie A 
Published: April 2021

ABSTRACT
Spinal column and cord injuries are rare in children and adolescents, and few reports in the literature that specifically address this subject. A retrospective review of medical records and radiographs of 57 patients was undertaken to identify age-related injury patterns, the incidence of neurologic deficits, and the presence of associated injuries. The most common injury in very young patients was spinal cord injury without radiographic abnormality or spinal cord injury with noncontiguous radiographic abnormality. The most common injury in older children was flexion-distraction injury, often associated with intraabdominal trauma. Adolescents tended to sustain injury patterns similar to adults.
TISSUE REPAIR USING LASERS: A REVIEW
Authors: Dew Douglas K , Supik Larry , Darrow Clement R , Price George F 
Published: April 2021

ABSTRACT
Numerous attempts have been made to use heating of tissue to effect an anastomotic union of severed tissue edges. Improvements in electrocautery and lasers have made experimental tissue anastomosis feasible; but clinical application of tissue welding has involved only limited clinical trials. Using heat to anastomose tissue is fraught with complications. The factors that lead to successful tissue welding and the technique's limitations are reviewed.
SUCCESSFUL TREATMENT FOR PHANTOM PAIN
Authors: Davis Roger W 
Published: April 2021

ABSTRACT
This article reports a series of 31 patients with true phantom pain. Mexiietine was used in an open-label study to evaluate its effectiveness in the treatment of this disorder. Eighteen of these patients had good to excellent results with mexiletine alone. Eleven other patients responded favorably with a combination of mexiletine and Clonidine. Two patients did not respond to either drug alone or in combination. Three patients elected to discontinue use of the mexiletine because of persistent nausea, even at low doses.