Securement of the indwelling urinary catheter for adult patients: a best practice implementation.

AIM: The evidence-based project sought to improve knowledge and practice in the care and securement of indwelling urinary catheters. METHODS: The project utilized a pre and post-implementation audit strategy, with the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice programs. The best practice recommendations on the care and securement of indwelling urinary catheters were retrieved from the Joanna Briggs Institute Clinical Online Network of Evidence for Care and Therapeutics database. A proposed urinary catheter securement practice, which included the use of a specifically designed securement device, was developed and implemented based on these recommendations. The implemented practice was evaluated with an audit tool which comprised two criteria recommended by the Joanna Briggs Institute Practical Application of Clinical Evidence System on the topic: Appropriate Catheter Use and Management. Audit criteria outcomes included staff compliance to training for urinary catheter securement and care and effectiveness of the implemented practice utilized to secure urinary catheters. The project was conducted in a general surgical ward over a period of 14 months, from December 2013 to January 2015. A sample of 30 inpatients was recruited at each audit phase. The sample size was decided based on recommendations from the Joint Commission International guidelines. RESULTS: A comparison between baseline and post-implementation audit findings indicated significant improvements in both audit criteria outcomes. For the first criterion, 100% compliance (P < 0.001) was achieved with all ward nurses being trained in application and care of the proposed urinary catheter securement practice. Criterion 2, which measured the effectiveness of the implemented practice, showed a nine-fold improvement from 10 to 90% (P < 0.001). A sustenance audit conducted 6 months post-implementation showed that compliance rates maintained at 100% for criterion 1 (P < 0.001), with further improvement from 90 to 100% for criterion 2 (P < 0.001). CONCLUSION: The proposed indwelling urinary catheter securement practice is an effective alternative to existing nursing practices. The use of a specifically designed securement device is found to complement and enhance the quality of urinary catheter securement. Nurses exhibited greater competency and knowledge in the application and care for urinary catheter securement.

The effects of sedative music on sleep quality of older community-dwelling adults in Singapore.

OBJECTIVES: To examine the effects of music listening on sleep quality amongst older community-dwelling adults in Singapore. METHODS: In a randomized controlled study, a cohort of older adults (N=60) age 55 years or above were recruited in one community centre. Sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI), was the primary outcome. Participants' demographic variables including age, gender, religion, education level, marital and financial status, any chronic illness, previous experiences of music intervention as well as depression levels were collected. Participants were asked to listen to soft, instrumental slow sedative music without lyrics, of approximately 60-80 beats per minute, and 40 min in duration, for 6 weeks. Generalized estimating equations were used to examine the effects of the intervention on the elders' sleep quality. RESULTS: Significant reductions in PSQI scores were found in the intervention group (n=28) from baseline (mean±SD, 10.2±2.5) to week 6 (5.9±2.4, p<0.001), while there were no changes in the control group (n=32) from baseline (9.0±2.4) to week 6 (9.5±2.6). At week 6, the intervention group showed a better sleep quality than the control (χ(2)=61.84, p<0.001). CONCLUSIONS: Notwithstanding the placebo effect, this study supports music listening as an effective intervention for older adults to improve sleep quality. Not only does this process improve their sleeping quality at old age, it also individualizes and enhances the quality of care provided by the healthcare provider as the therapeutic relationship between provider and client is being established. Contemporary gerontology is progressively characterized by collaboration between several approaches with the intent to comprehend the mental aspects of the multifarious process of ageing. Music listening is one such avenue to enhance sleep quality amongst older adults and make an essential contribution to healthy ageing.

A contact lens with embedded sensor for monitoring tear glucose level.

We report the design, construction, and testing of a contact lens with an integrated amperometric glucose sensor, proposing the possibility of in situ human health monitoring simply by wearing a contact lens. The glucose sensor was constructed by creating microstructures on a polymer substrate, which was subsequently shaped into a contact lens. Titania sol-gel film was applied to immobilize glucose oxidase, and Nafion® was used to decrease several potential interferences (ascorbic acid, lactate, and urea) present in the tear film. The sensor exhibits a fast response (20s), a high sensitivity (240 µA cm(-2) mM(-1)) and a good reproducibility after testing a number of sensors. It shows good linearity for the typical range of glucose concentrations in the tear film (0.1-0.6 mM), and acceptable accuracy in the presence of interfering agents. The sensor can attain a minimum detection of less than 0.01 mM glucose.