ABSTRACT
This study sought to improve nursing staff understanding regarding the differences in postoperative management between patients who have undergone tracheostomy and laryngectomy. The intervention involved a brief didactic session followed by the placement of an informative poster and anatomic diagram above the bed of tracheostomy and laryngectomy patients over a 6-month period. Data were collected before and after the didactic session and poster implementation. Of the 50 nurses surveyed, 32% believed oral ventilation is appropriate for laryngectomy patients compared to 0% of nurses after the intervention. The percentage of nursing staff reporting self-assessed clear understanding of the patient care differences between laryngectomy and tracheostomy improved after the intervention. The use of informational posters and didactic sessions significantly improves nursing staff understanding of the differences between tracheostomy and laryngectomy patients. Level of Evidence: IV.
ABSTRACT
AIMS: In this study, we analysed the frequency of C-reactive protein (CRP) use in the management of acute medical admissions, the clinical reasoning behind it, and its contribution (if any) to clinical management. Our aim was to gauge the current clinical criteria used for the ordering of CRP. METHODS: We performed a retrospective analysis of a representative sample of 171 patients who had C-reactive protein assays ordered. We compiled criteria whereby each order could be deemed either clinically indicated or inappropriate. RESULTS: In these patients, 264 orders for CRP were made. Of these 133 (50.38%) were deemed inappropriate to the clinical scenario. The reasons for the order being inappropriate were: clinically obvious infections where the result made no difference to treatment choice (47.37%); serial measurements in patients who were clinically improving (33.58%); and CRP measurements in patients presenting with symptoms unlikely due to an infective or inflammatory processes (19.55%). CONCLUSION: 50.38% of C-reactive protein assays ordered in this study were clinically unnecessary, representing not only poor clinical judgement but also poor use of laboratory time and expenditure.
