Evaluating the Effectiveness of the m-ROMPIS Scale in Preventing Pressure Injuries in Intubated ICU Patients: A Clinical Intervention Study

Medical device-related pressure injuries (MDRPIs) occur in up to 34% of patients, with oral pressure injuries affecting as many as 45% of ICU patients. The modified Reaper Oral Mucosa Pressure Injury Scale (m-ROMPIS) offers a standardized approach to improve early detection and management... The successful pilot led to the development of a Clinical Practice Guideline (CPG) and plans for broader adoption of the m-ROMPIS tool through stakeholder engagement, leadership collaboration, and workflow optimization

Sodium Bicarbonate Implications During Coronary Artery Bypass Grafting

Acidemia is common in cardiac patients undergoing coronary artery bypass graft (CABG) surgery. Acute metabolic acidosis (MA) during CABG surgery is typically an indication of tissue hypoperfusion.1,2,3,4 This pH imbalance is thought to contribute to cardiac instability, reduced responsiveness to vasopressors, and increased mortality.1,2,5 As a result, anesthesia providers commonly administer sodium bicarbonate (SB) in efforts to correct the pH imbalance and restore cardiac function.1 Despite its prevalence, little evidence supports treating hypoperfusion-related MA with SB. This leads to the question, in patients undergoing CABG who develop MA intraoperatively, does correcting the pH with SB reduce postoperative mortality

Diabetic foot ulcers: Prevention, assessment and management (3rd ed.)

The purpose of this guideline is to provide nurses and members of the interprofessional team, persons at risk of or living with a diabetic foot ulcer (DFU) and their care partners with evidence-based recommendations on the prevention, assessment and management of DFUs.This BPG is to be used by nurses and members of the interprofessional team across the health care continuum and in all domains of practice supporting adults at risk of or living with DFUs (i.e., greater than 18 years of age) and their care partners. It is also to be used by employers, including health service organizations and academic institutions.The following populations and topics are not covered within the scope of this BPG: persons less than 18 years of age prescribing treatments adjunctive or alternative treatment

Multidimensional Approach to Assessing Pain in Hospice Patients

Patients are admitted to hospice care with a terminal illness to receive supportive care and management of symptoms, such as pain. An integral part of the nursing role is providing holistic care by assessing the patient\u27s physical, mental, emotional, and overall functional state. To improve quality at end-of-life, a comprehensive assessment of the patient’s pain experience should occur during every visit. Inadequate pain assessment is a local and national problem resulting from the use of unidimensional pain assessment tools, such as the numerical pain rating scale and visual analog scale, which measures generalized pain rather than the overall pain experience. Currently, nurses at a local hospice company use a unidimensional approach to assess pain during routine visits. Literature recommend using a multidimensional pain assessment method to better understand the patient\u27s total pain experience and increase comfort and patient satisfaction. The purpose of this planned project was to develop an evidence-based multidimensional pain assessment approach for hospice patients, including plans for implementation and evaluation

Identification and Management of Difficult Airways

Airway management is a critical aspect of anesthetic practice, particularly in patients presenting with multiple clinical signs indicating a potentially difficult airway (DA). This case report examined utilization of the difficult airway algorithm in a 48-year-old male patient who presented for maxillomandibular advancement surgery due to chronic obstructive sleep apnea (OSA). Despite advancements in airway management technology, the incidence of adverse events remains a concern, particularly in patients with anatomic characteristics consistent with DA. The creation and use of standardized protocols to include these recommendations for DA management optimizes patient outcomes by reducing errors in practitioner judgment. This poster presentation includes tools to be used for the identification and management of DA, including a clinical practice algorithm to follow when DA is suspected during the preoperative period

Ondansetron for Propofol Injection Pain

Propofol injection pain can be the most distressing part of a patient’s peri-operative experience. The current standard of practice is to use intravenous (IV) lidocaine to blunt the pain on injection caused by propofol; however, this does not guarantee a comfortable, satisfactory induction for the patient..

Non-ventilated prone positioning in the COVID-19 population

In the population of confirmed COVID-19 positive patients on a telemetry unit, will proning every 2 hours result in a decreased length of stay for the intervention group (patients that prone) as opposed to the control group (patients that receive standard of care) over a period of 9 months (2021-2022)

Post-Traumatic Stress Disorder Symptom Scale and Coping Mechanisms among Internally Displaced Persons of Typhoon Yolanda

The study aimed to determine the Post-Traumatic Stress Disorder Symptom Scale and the Coping Mechanisms utilized by the Internally Displaced Persons of Typhoon Yolanda. It sought to identify the profile, risk factors of the respondents, the Post-Traumatic Stress Disorder (PTSD) symptoms manifested and coping mechanisms utilized. The study also distinguished the differences in PTSD and Coping mechanisms when respondents are grouped according to their profile and death of family members and examined the relationship of PTSD and Coping. The study adopted the PTSD Symptom Scale and Brief COPE Inventory questionnaires and were consequently translated to Visayan-Waray. These were then pilot-tested with high reliability scores. Statistical treatments were then applied to reveal the findings of the study. The respondents were 73.3 percent female, while 55.3 percent were middle-aged adults, and 42 percent finished high school. It also revealed that 64.7 percent were married, 60 percent were employed, 57.3 percent were earning less than P40,000 annual family income, and 76 percent stayed in the bunkhouses between 19 to 20 months. Out of the 150 respondents, 56 have only one death among their family members. As to the injuries sustained during the typhoon, 67 respondents reported no injuries. The respondents who lost their appliances, cash and homes to the typhoon were 149, 145 and 100, respectively. With regard to the PTSD Symptom scale, the most common symptom manifested by the respondents was Avoidance of the Stimuli (WM=2.28). This was followed by symptoms of Intrusions (WM=1.83), Increased Arousal and Reactivity (WM=1.31) and Changes in Cognition and Mood (WM=1.12) and manifested Symptom of Distress (WM=1.61). It was further revealed that 56 percent had symptom onset in less than 6 months, 86 percent had a symptom duration of more than 1 month, 53.3 percent have probable diagnosis of PTSD and the Symptoms were also endured at severe levels by 40 percent of the respondents. As to the coping mechanisms utilized, it was revealed that Religion (WM=2.96) was the most frequently used coping. Other coping mechanisms used frequently were: Planning (WM=2.89), Active Coping (WM=2.80), Positive Reframing (WM=2.71), Acceptance (WM=2.69), and Self-Distraction (WM=2.59). Meanwhile, occasionally used coping mechanisms are: Venting (WM=2.37); Use of Emotional Support (WM=2.30); Humor (WM=2.01); Behavioral Disengagement (WM=1.95); Use of Instrumental Support (WM=1.81); and Denial (WM=1.53). Rarely used was Self-Blame (WM 1.10) while Substance Use (WM=0.35) was found to be never used. Significant differences were found in: gender and PTSD probable diagnosis (p=0.048); civil status with distress (p=0.028) and severity (p=0.001); highest educational attainment and changes in cognition and mood (p=0.010); average annual family income and symptom onset (p=0.007); length of stay in the bunkhouses and symptom onset (p=0.038); death of family members with changes in cognition and mood (p=0.038) and symptom onset (p=0.013). As to the coping mechanisms, it was deduced from the grand p results that no significant differences were noted when respondents were grouped to profile and death of family members. The study also determined significant relationships in the PTSD Symptom Scale and Coping Mechanisms among the IDPs of typhoon Yolanda. Specifically, it identified the relationships of coping mechanism with the symptoms of avoidance of the stimuli (p=0.000), changes in cognition and mood (p=0.022), increased arousal and reactivity (p=0.001), and symptom onset (p=0.033) and severity (p=0.020)

Perspectives of Latino Adolescents: Cultural Beliefs and Practices about Health Literacy

The purpose of this study is to explore the cultural beliefs and practices of Latino adolescents related to acquisition and utilization of health information. Although there is growing research in health literacy specific to adolescents, limited data is available to illuminate aspects of health literacy in the Latino adolescent population. Available studies focus on testing interventions to improve health literacy but fall short of providing an understanding of how specific cultural groups acquire and use health information. This study aims to seek culturally specific information from Latino adolescents, which can ultimately lead to increasing the healthcare providers understanding of how cultural beliefs concerning health literacy influence cultural practices

Exploring Knowledge, Attitudes, and Practices of Healthcare Providers in Addressing the Care Needs of Individuals who identify as LGBTQIA+ : A Mixed-Method Study

This mixed-methodological study explores the knowledge, attitudes, and practices of healthcare providers (HCPs) and also gathers and analyzes their narrative experiences addressing the care needs of individuals who self-identify as LGBTQIA+. A s ociodemographic form, Knowledge and Practices to Address the Care Needs of LGBTQIA+ Individual Survey, and the Implicit Association T est ( Sexuality IAT and Transpictures IAT) were used as to collect quantitative data from 278 nurses and physicians. S emi-structured in-depth interviews were then held with 15 of these study participants.Quantitative findings revealed slight implicit attitudes favoring heterosexual and cisgender individuals, with education level and personal connections to LGBTQIA+ individuals positively associated with knowledge and with inclusive practices. Qualitative data analysis yielded three themes: (i) Lack of cultural competence in services, (ii) Structural and systemic heterosexism, and (iii) Awareness of Barriers to formal healthcare-seeking: Stigma and Exclusion. The outcomes of this study underscore the need for enhanced training, inclusive curricula, and culturally humble healthcare provision to address HCPs\u27 knowledge, attitudes, and practices regarding LGBTQAI+ healthcare