ABSTRACT
Modern health care has evolved into technological wizardry that defies the traditional concept of caring by the bedside nurse. Industry constraints have created an environment where caring for the patient and employee has become easily discarded in favor of the rigors of technological care. With an aging and diminished work force, nursing leaders must be prepared to create a caring environment where nurses are empowered to deliver the humanitarian as well as technological aspects of caring. From a concept of work redesign that mirrors traditional nursing paradigms, nurses can enrich not only their professional work environment but also deliver the high touch aspect of care in their daily work.
Subject(s)
Empathy , Nurse-Patient Relations , Nursing Staff/organization & administration , Organizational Culture , Humans , Leadership , Models, Organizational , Organizational InnovationABSTRACT
Greater use of computer technology has permitted rapid access to many forms of data. Hospitals have traditionally been slower to accept this technology for patient medical records. With the rapid approach of the new millennium, hospitals are being forced into re-evaluating many processes, including the volumes of data collected on paper. Electronic medical records are one approach to reducing storage and streamlining care across the health care continuum. This article examines the ethical impact of computerized medical records, including access to data, ownership of data, confidentiality, and medical record brokering.
Subject(s)
Confidentiality , Ethics, Nursing , Medical Records Systems, Computerized/standards , Computer Security/legislation & jurisprudence , Computer Security/standards , Confidentiality/legislation & jurisprudence , Humans , Medical Records Systems, Computerized/legislation & jurisprudence , Patient Advocacy/legislation & jurisprudence , Research/legislation & jurisprudence , United StatesABSTRACT
Application of pressure infusion bags may increase intravenous (IV) flow rates three-fold. Commercially available pressure infusers, manual squeezing of the IV fluid bag, inflating a blood pressure (BP) cuff around the bag, and kneeling on the bag have been used by prehospital personnel attempting to augment fluid infusion rates. To test the efficacy of each these methods, seven experienced paramedics were asked to employ each method in two trials using a 1-liter bag of saline through a 14-gauge, 5.7cm catheter and a standard administration set. Gravity flow from 80 cm served as the control. Pressure infusers generated flow rates of 257+/-54 ml/min and 296+/-53 ml/min when inflated to 300 mmHg and maximum pressure respectively. This rate was 2-2.5 times that of gravity flow (123+/-2 ml/min) and significantly greater than those rates obtained by any other method (p less than .0005). Manually squeezing the bag also was significantly better than was gravity flow with flow rates of 184+/-46 ml/min and 173+/-40 ml/min achieved by each of two different squeezing methods (p less than .01). Neither blood pressure (BP) cuff application and inflation (135+/-28 ml/min) nor kneeling on the bag (125+/-36 ml/min) was better than gravity alone. These results indicate that pressure infusers should be used to the exclusion of other field methods of supplying infusion pressure. If pressure infusers are not available, manually squeezing the bag is the only alternative acceptable in the field.