ABSTRACT
Professional nurses are expected to read and evaluate nursing research. Many nurses' report feeling intimated by research studies. The Applicability, Science, Knowledge Model offers the basics needed to quickly review and grasp the potential clinical significance of a journal study. Using a research report previously published in the Journal of Trauma Nursing, the authors demonstrate the critique process. Key points for critical understanding and guidelines for application to practice are presented.
Subject(s)
Evidence-Based Medicine/methods , Guidelines as Topic , Nursing Research , Emergency Nursing , Humans , Periodicals as Topic , Wounds and Injuries/nursingABSTRACT
PURPOSE: To describe the clinical presentation of patients with blunt abdominal trauma undergoing nonoperative management of spleen or liver lacerations for identification of pertinent assessment findings indicative of the impending need for surgical intervention. METHODS: A retrospective study utilizing medical records for a 5 year period of adult blunt trauma patients with a diagnosis of spleen or liver laceration were reviewed. FINDINGS: Patients who failed nonoperative management of spleen or liver lacerations had statistically different measurements of heart rate, uncontrolled pain, skin color and temperature, numbers of units of blood received, urgent computed tomography scans, and serial hemoglobin levels. CONCLUSIONS: Nursing observations are crucial to the early identification of bleeding in patients with blunt abdominal trauma.
Subject(s)
Liver/injuries , Nursing Assessment/methods , Spleen/injuries , Wounds, Nonpenetrating/nursing , Adult , Female , Humans , Male , Retrospective Studies , Wounds, Nonpenetrating/diagnosis , Wounds, Nonpenetrating/surgeryABSTRACT
BACKGROUND: This study examined the adequacy of oral contrast (OC) in adult trauma patients, the differences in the incidence of pathology and other patient characteristics related to OC adequacy, and the incidence of OC-associated emesis. METHODS: The cases of 129 adult trauma patients were reviewed from January to December 1996 for utilization of OC, administration time, time to computed tomography (CT), and emesis within 4 hours. CT films were reviewed for adequacy of OC (AC = adequate contrast, IC = inadequate contrast) and pathology. RESULTS: Data are presented as median and range, or percentage and 95% confidence interval (CI). Pathology was found in 24% (CI 17% to 31%) and was not associated with AC. OC administration to CT was 14 minutes (0 to 139). IC was present for 60% (CI 52% to 69%). Subjects with IC had higher injury severity scores. 10% (CI 5% to 15%) with OC had emesis. CONCLUSION: OC is not necessary for diagnostic accuracy, and may contribute to patient morbidity or discomfort.
Subject(s)
Contrast Media/administration & dosage , Tomography, X-Ray Computed/standards , Wounds and Injuries/diagnostic imaging , Administration, Oral , Adolescent , Adult , Aged , Aged, 80 and over , Contrast Media/adverse effects , Female , Humans , Male , Middle Aged , Retrospective Studies , Sensitivity and Specificity , Severity of Illness Index , Vomiting/chemically inducedSubject(s)
Abscess/etiology , Catheterization, Peripheral/adverse effects , Catheterization, Peripheral/standards , Emergency Medical Services/standards , Multiple Trauma/therapy , Total Quality Management/organization & administration , Abscess/prevention & control , Algorithms , Catheterization, Peripheral/methods , Decision Trees , Emergency Medical Services/methods , Humans , Infection Control/methods , Infection Control/standards , Practice Guidelines as Topic , Prospective Studies , Risk FactorsABSTRACT
PURPOSE: To evaluate the Student Alcohol Questionnaire (SAQ) for use drinking/driving prevention programs in college-age students. METHODS: A pilot study of 39 students was conducted, which included a pre-test covering demographics and using the SAQ. A post-test was given as a program evaluation. The SAQ was repeated one month later. FINDINGS: At program completion, 40% of students stated that they would change behavior. The SAQ findings revealed no statistically significant changes in the pre- and post-tests. CONCLUSIONS: The SAQ may be an effective tool for measuring prevention programs.
Subject(s)
Accidents, Traffic/prevention & control , Alcohol Drinking/prevention & control , Automobile Driving , Multiple Trauma/prevention & control , Students/psychology , Surveys and Questionnaires/standards , Adolescent , Adult , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Pilot Projects , Reproducibility of Results , UniversitiesABSTRACT
PURPOSE: To identify adherence to the standard that trauma patients have body temperature (T) recorded, range-of-temperature measurements, and the incidence of hypothermia recorded; and to examine the relationship between (T) and Injury Severity Score (ISS). METHODS: A retrospective review of the records of 60 trauma patients was conducted. FINDINGS: Forty percent of the patient records had temperatures recorded with values that ranged from (T) 87-100.6 degrees F; 33% of the patients had hypothermia as defined by a temperature of 96.6 degrees F or less. There appeared to be a significant inverse relationship between (T) and ISS. CONCLUSIONS: Based on the data, temperature was recorded in only 40% of the cases sampled. Adherence to the standard of measuring and recording a value was only intermittently followed. Nursing personnel should be educated to appreciate the potential for unsuspected hypothermia and to respond by following the standards of care.
