bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do ready-made compression stockings fit the anatomy of the venous leg ulcer patient?
Authors: Nørregaard S. , Bermark S. , Gottrup F. 
Published: May 2014

Objective: How usable two standardised measuring methods are for the selection of three different brands of ready-made below-knee compression stockings. Furthermore, this study aims to determine how many of the included patients fit into a ready-made compression stocking in a limited selection of brands. Method: Consecutive patients suffering from venous insufficiency and treated at a specialised wound healing centre were included in this prospective comparative study. Two standardised measuring methods were used to evaluate the suitability of three different brands of ready-made below knee compression stockings. The circumference was measured at three points and seven points below the knee. The results of these measurements were compared to three selected brands of ready-made compression stockings. Results: Together, 43 consecutive patients (25 men and 18 women) were included in the study. When the leg was measured at three points, 53.5%, 34.9% and 0% of the patients fitted into brand 1, brand 2 and brand 3 of the ready-made compression stockings, respectively. When measured at seven points, only 4.7% of the patients fitted into brand 1, 7% in brand 2 and 0% of the patients fitted into brand 3. Conclusion: These results demonstrate that there is a need to standardise measuring methods in the selection of ready-made below-knee compression stockings and a need for an evaluation of the present stocking sizes in relation to the anatomy of the venous leg ulcer patient. This study has shown that ready-made compression stockings presently prescribed will not properly fit the majority of patients to prevent oedema and ulcer recurrence. Further studies focused on the development of new sizes or changes in fitting recommendations may help solve these problems. Declaration of interest: There were no external sources of funding for this study. The authors have no conflicts of interest to declare with regard to the manuscript or its content.
Aqueous oxygen peroxide treatment of VLUs in a primary care-based randomised, double-blind, placebo-controlled trial
Authors: O'Halloran P.D. , Winter P.K. , Otter J.A. , Adams N.M.T. , Chewins J. 
Published: May 2014

Objective: To evaluate a novel aqueous oxygen peroxide (AOP) wound therapy (BioxyQuell) in a multi-centre, primary care-based, randomised, double-blind, placebo-controlled, parallel-group trial, monitoring long-term healing outcomes over 12 months. Method: Sixty-one patients with chronic, stable venous leg ulceration were treated with either AOP solution or sterile water placebo applied as a lavage over 2 weeks. The patients’ wounds were dressed weekly and assessed fortnightly over the following 6 weeks. Patients who completed the initial 8-week trial were invited into a 10-month follow-up trial. The primary endpoints of the study were wound healing at 8 weeks, 12 weeks, 6 months and 12 months, and wound size reduction during the treatment phase. Secondary endpoints were reductions in wound bioburden and pain. Results: Patients treated with AOP were more likely to heal at 6 months (p=0.014) and 12 months (p=0.006), but not at 8 weeks (p=0.979) or 12 weeks (p=0.263). Patients treated with AOP had greater wound area reduction (p=0.015), reductions in pain measured on a 100-point scale (p=0.001) and wound bioburden reduction (p=0.005) during the treatment phase. Conclusion: The addition of AOP treatment provides substantial benefits to patients with chronic venous leg ulceration compared with current best practice. Declaration of interest: This work was supported by Bioquell UK Ltd, manufacturers of the BioxyQuell system. Authors P. Winter, J. Otter, N. Adams and J. Chewins are employees of Bioquell UK Ltd.
Arterial blood gas and electrolyte measurement on air ambulances
Authors: Williams Hannah M , Bleetman Anthony 
Published: May 2014

Arterial blood gas and electrolyte analyses are routinely conducted for critically unwell patients in the hospital setting. Modern and portable point-of care analysers now allow these tests to be performed in the pre-hospital setting. A small number of studies have looked at the potential for performing these tests in the prehospital setting and identified that on-scene testing can alter management of these critical patients. Aims To look at the feasibility of introducing a point-of-care arterial blood gas and electrolyte analyser onto a medically-led air ambulance service. Methods A retrospective review of the mission data for Warwickshire and Northamptonshire Air Ambulance (WNAA) for all missions between 1st January 2007 and 31st December 2007 was conducted. Patients who could potentially benefit from pointof- care analysis were identified. The physical properties of the i-STAT machine were analysed, specifically the operating temperature range. Air ambulance crew members were asked for their opinions on the potential of point-of-care analysers. Results The i-STAT machine could potentially have been used in 174 out of 414 patients (42%) transferred by the air ambulance. The most common indication for use would have been head-injured patients. The operating temperature range of the point-of-care analyser (16–30°C) and the associated temperature drop when the aircraft is flying at 1000 feet means that the machine would only be functional between June and late August (assuming normal seasonal maximum temperatures). Crew members felt that due to the short flight time for primary transfer to hospital, the impact on patient outcome would not be significant for the majority of patients. Conclusions The benefit of performing point-of-care analysis on air ambulance patients remains uncertain. The operating temperature range will also limit the i-STAT machine use on air ambulances.
The role of paramedics with extended practice: exploring the healthcare context
Authors: Catterall Matthew 
Published: May 2014

With National Health Service (NHS) providers facing the challenge of measurement through clinical outcomes, measures of effective service provision, this article explores the political influences; background and current approaches which have expanded paramedics’ scope of practice.As there are conflicting demands upon ambulance service NHS trusts provision of healthcare, these features are related to experiences within the London Ambulance Service, and where relevant to national experiences. The educational requirements, practitioner attributes, leadership development and service user perception are explored.In an environment where paramedics are expected to deliver innovative healthcare, partly driven by political influence it is important to understand how an extended scope of practice has involved and can be delivered while ensuring patient safety. In helping to shape the future delivery of out-of-hospital healthcare while integrating in the changing urgent and emergency provision, paramedics must remain aware of these multifaceted drivers upon their practice.
Interpersonal skills education for undergraduate nurses and paramedics
Authors: Ross Linda 
Published: May 2014

Interpersonal skills can be described and defined in numerous ways; however a common premise throughout the literature is that they are linked to human interaction and contribute substantially to establishing a high quality caring relationship with patients. Furthermore they are paramount to nurses’ and paramedics’ abilities to operate within diverse, challenging environments and highly charged emotional situations. The aim of this review was to explore how undergraduate programmes are teaching these skills and with what outcomes. Methods A literature search was conducted using electronic databases, Medline, EMBASE, PsycINFO and ERIC. Results 2838 articles were initially identified with only 6 remaining for analysis after applying the inclusion/exclusion criteria. No relevant data pertaining to paramedic undergraduate interpersonal skills was located for inclusion. Undergraduate nursing programmes used more traditional classroom approaches in conjunction with engaging, highly realistic activities. The use of evaluation tools in combination with student self-reporting appeared to be the most thorough and accurate way of evaluating such humanistic skills which are more difficult to quantify than clinically based skills. Conclusion This literature review has highlighted the lack of research into the teaching and development of interpersonal skills in undergraduate paramedic programmes and a need for this to occur in the future.
Kerbside consultations: advice from the advanced paramedic to the frontline
Authors: Jackson Mike , Jones Colin 
Published: May 2014

Aim To observe the issues, benefits and challenges of providing dynamic telephone clinical advice to frontline clinicians by advanced paramedics of the North West Ambulance Service NHS Trust. Method In order to focus on the key issues the study used a mixed method approach. A group of 11 advanced paramedics took part in two focus groups which was then followed up with a questionnaire to frontline clinicians. Using focus groups in the research not only allows for the possibility of multiple realities but also for participant validation. Using a qualitative approach allowed theory to develop and emerge which was then codified into themes and the data was then used to develop a questionnaire for frontline clinicians who had received clinical advice in the past in order to provide an element of quantitative data. Findings Five themes emerged from the stud: function, responsibility, barriers, education and support. Conclusion The study finds that clarity is required in relation to responsibilities and clinicians would benefit from a structured model to communicate information over the telephone—we believe the introduction of remote advice has improved patient safety and support to staff and has created opportunity for additional learning.
Evaluating the incidence of unrecognised oesophageal intubation by paramedics
Authors: Nichols Martin , Acker Joe , Bendall Jason , Asha Stephen 
Published: May 2014

Objective: To determine the incidence of unrecognised oesophageal intubation by paramedics in a metropolitan setting. Methods: A retrospective observational analysis was conducted. Patient health care records from the Ambulance Service of New South Wales were used to identify patients who had been intubated by paramedics between 1 January 2007 and 31 December 2010, and transported to St George Hospital, Sydney. Medical records from St George Hospital were reviewed to determine the position of the endotracheal tube (ETT) on arrival in the Emergency Department. Results: During the study period, 196 patients were identified as having an ETT in-situ on arrival to the emergency department. There was inadequate documentation for 67 patients to determine ETT placement. Of the 129 patients included in the final analysis, 4 (3.1%, 95% confidence interval (CI) 0.9–7.8%) had an unrecognised oesophageal intubation. The final ETT positions of the remaining 125 patients were 85.3% (95% CI 78–90.9%) located in the trachea, 10.1% (95% CI 5.5–16.6%) located in a primary bronchus, 0.8% (95% CI 0–4.2%) in the larynx and 0.8% (95% CI 0–4.2%) in the pharynx. Conclusion: The incidence of unrecognised oesophageal intubations in this study was consistent with other reports in the literature, although higher than expected given the training and equipment used in this setting. An incidence of unrecognised oesophageal intubations of zero should be the goal of emergency medical services. The incidence of unrecognised oesophageal intubations may be reduced through recursive training programs and the use of quantitative waveform capnography.
How nurse prescribing influences the role of nursing
Authors: Stenner Karen , Carey Nicola , Courtenay Molly 
Published: May 2014

Because role change can be disruptive, the introduction of nurse prescribing could potentially lead to confusion and conflict over role boundaries and definitions. This article considers how adopting prescribing has influenced the role of nurse prescribers who treat and manage patients with diabetes. Interviews with 10 nurse prescribers, nine doctors and three non-prescribing nurses were collected as part of a case study of nine UK sites where nurses prescribed medicines for patients with diabetes. We found that nurses resisted the ‘medicalization’ of their role. They strove to ensure that their consultations continued to follow a ‘nursing model’ which involved holistic assessment, health promotion and patient-centred care. There were perceived differences in the level of decision-making between doctors and nurse prescribers. To conclude, nurses adopted prescribing while maintaining a nursing approach to practice. For specialist nurses, this expanded role included higher levels of decision-making more traditionally associated with doctors.
Research roundup: April 2014
Authors: Mark Greener 
Published: May 2014

In brief ▪ Side effects of antidepressants may be more frequent than previously reported ▪ Nurses have a variety of approaches to increase patient adherence to psychiatric medications ▪ Women who have smoked at some time during their reproductive years are more likely to experience spontaneous abortion, ectopic pregnancy and stillbirth ▪ Reduction in onset-to-treatment time in stroke patients results in an increase in disability-free life ▪ Prehypertension increases stroke risk ▪ Drug-drug interactions are a significant cause of hospital admissions
Do PNs Want to Learn About Depression?
Authors: Armstrong Liz 
Published: May 2014

The recently established National Depression Care Training Centre (NDCTC) commissioned a survey to establish the training needs of practice nurses nationwide. A questionnaire was sent to 3000 nurses who had attended National Asthma and Respiratory Training Centre courses in the last 10 years. The response rate was 30% (1006) and revealed that the majority of respondents felt they did not have enough knowledge of diagnosing and treating depression. Even among those who had attended courses confidence in dealing with depression was very low. In order to begin to tackle this situation, NDCTC has designed a 2-day pilot course which will be held initially at Nene College Northampton. This is an introductory course and developments will follow.
PNs: Facilitators of Learning?
Authors: Carter Rachel 
Published: May 2014

This study considered the feasibility of practice nurses supervising Diploma of Higher Education (Nursing) students for a short practice placement. Ten practice nurses facilitated a 10 day placement at the commencement of the Branch Programme. The results of this placement were compared to that of a control group of ten students who were facilitated by health visitors, the usual practice placement at this time. Information was gathered from both facilitators and students prior to and upon completion of the placement through interview and questionnaire. It was found that students facilitated by practice nurses consistently move further forward in their learning outcomes and competency than students facilitated by health visitors. The study demonstrated that practice nurses are a valuable resource for educating students which has to date not been appropriately utilised
Access to travel health resources in Wales
Authors: Joyce Nicola , Cottrell Simon , Roberts Richard 
Published: May 2014

There is limited information about decision-making by nurses during travel health consultations in general practice, and on practice nurses' access to travel health training. A postal questionnaire was sent to the senior practice nurse in all 528 general practices in Wales to investigate nurses' travel health training and use of information resources. Results. The response rate was 48%. Almost half of respondents had accessed a training course within the last year and a majority used respected paper or online sources of travel health information. Recent training had a positive effect on the use of online resources. Conclusions. Practice nurses' access to travel health training in Wales often depends on the size of the practice. It is important for practice nurses to consider their travel health training and information needs. Nurses need support from practices and primary care organizations to ensure that they can access to up-to-date information and training.
Manuka honey: an effective wound healing environment
Authors: Hollis Georgie 
Published: May 2014

Honey has been used for over 4000 years making it one of the oldest recorded therapies for treating wounds. Routinely and independently used over many different continents it was clearly a reliable method for wound management that had stood the test of time. The suggestion of honey for wounds today can still be looked upon as somewhat ‘alternative’. But in only a couple of years the use of honey, particlulary Activon Manuka Honey (Dechra Veterinary Products Ltd, Shrewsbury, Shropshire, UK) has become a popular and successful treatment for all manner of veterinary wounds. This product focus explores some of the science behind honey, why manuka is preferential and how it has been used to date in veterinary patients.
Cuffed endotracheal intubation in cats
Authors: Adshead Samantha 
Published: May 2014

Cuffed endotracheal (ET) intubation is used by many veterinary practitioners when anaesthetizing the feline patient. Cuffed ET intubation can, however, result in tracheal injury due to the delicate feline trachea and is a well-documented cause of Veterinary Defence Society claims. This article examines the anatomy and physiology of the trachea and considers why it is susceptible to trauma relating to cuffed ET intubation. It explores current research into tracheal trauma and the findings relating to the cause of injury and suggests specific practical techniques which can minimize the potential damage to the trachea as a result of cuffed ET intubation. These include the choice of ET tubes, the mode of inflation, precautions that can be taken while moving the animal and intra-operative monitoring. It concludes that there are relatively simple ways in which the likelihood of such iatrogenic tracheal trauma can be minimized.
Aseptic skin preparation: reducing the risk of surgical site infection
Authors: Bowers Lynne 
Published: May 2014

Surgical site infection (SSI) is a potentially serious complication of surgery, with the consequences of infection varying from local inflammation to life threatening septicaemia. SSIs result in increased patient discomfort and client dissatisfaction due to prolonged periods of hospitalization and financial implications. Infections after surgery are often blamed on poor owner compliance or patient interference; however the patient's normal skin flora has been shown to be one of the leading causes of SSIs.Efforts to reduce patient sources of infection are aimed at decreasing the number of bacteria on the skin prior to surgery and reducing potential bacterial contamination from within the patient during surgery. This article will focus on the former of these sources via discussion of aseptic surgical skin preparation.
Peripheral intravenous catheters: improving patient safety with the use of a care bundle
Authors: Hancill Sarah 
Published: May 2014

Objective: To introduce a peripheral intravenous catheter (PVC) care bundle as a tool to improve the management of PVCs and patient safety, and to audit staff compliance over a 9 week period. The long-term goal was to use data from the pilot study to implement the PVC bundle in other veterinary practices. Methods: Over a period of 9 weeks, a PVC care bundle consisting of 14 quality indicators was introduced into Abbey House Veterinary Hospital, Leeds. This was to assess 49 patients who had an intravenous catheter in situ for more than 24 hours. Staff were asked to record on the PVC care bundle sheet when a quality indicator had been completed. Percentage compliance was then calculated for the completion of the entire bundle and the individual quality indicators. Results: Over the 9 week period there was an overall decline in compliance for the entire bundle. It declined by 3% from an initial compliance of 94. Regression analysis was performed to calculate whether this value was significant using a p value of ≤0.05. There were improvements in some of the individual quality indicators, for example date and time of insertion and checking the insertion site and limb. Conclusion: It was demonstrated that there was a low mean percentage compliance with completion of the care bundle in the hospital environment studied. However with more research and further implementation, changes could be made to the bundle to increase the rate of compliance, and improve patient safety.
Veterinary nurses creating a unique approach to patient care: part one
Authors: Welsh Perdi , Wager Catherine 
Published: May 2014

Veterinary nursing has experienced the immigration of new concepts and terminology relating to human nursing theories for a number of years, many of which, such as nursing models and care plans, are now integral parts of the veterinary nursing academic landscape. Despite this, it is proposed by the authors that veterinary nurses are, for various reasons, reluctant to incorporate care planning into their daily clinical practice, resulting in the development of a theory–practice divide. As there are published reports from veterinary nurses who have applied the Orpet and Jeffery Ability Model (2007) to their practice with successful outcomes, it is suggested that adoption of this veterinary nursing model provides the best chance of closing the theory–practice gap. When used in conjunction with the nursing process, the Orpet and Jeffery Ability Model (2007) can enable veterinary nurses to deliver a high standard of individualised nursing care to their patients in practice, in addition to further developing the profession as a whole.
Provenance and Manufacture of Mixtec Style Objects Found on the Surrounding Structures of the Precinct of the Great Temple of Tenochtitlan
Authors: Solís Ciriaco Ciriaco Reyna B. , Ruvalcaba Sil José L. 
Published: May 2014

ABSTRACTSeventy six speckled greenstone items have been recovered on the surrounding structures of the Aztec precinct of the Great Temple of Tenochtitlan. Several researchers have identified the material as marble. Also, these objects have been labeled as Mixtec style due to the raw materials involved in their manufacture as well as their apparent similarity with other known Mixtec objects. The main objective of this essay is to determine the raw materials and the technology employed on its manufacture. Based on earlier composition analysis using Infrared spectroscopy (FTIR) and X-ray Fluorescence (XRF), it became clear that all items are made of the same calcite-serpentine mineral alloy, which probably comes from the Oaxaca region. It is interesting the homogeneity and standardization among these pieces by analyzing them with experimental archaeology and the characterization of their manufacturing traces. Comparing their raw material, morphology and techniques with those of Mixtec sites, the analysis revealed that they are not in fact related at all; however they do coincide with the manufacturing process of Tenochca (Aztec) style objects. This fact might point towards the actual origin of the raw materials, their obtainment and the technology behind the elaboration of luxury goods at Tenochtitlan.