Pulse oximetry provides continuous, non-invasive monitoring of the oxygen saturation of haemoglobin in arterial blood, which is updated with each pulse wave. The primary advantage is that it detects immediately deviations to a patient's baseline. Care givers can therefore detect changes before the patient becomes hypoxaemic. However, staff are reported to have limited education, if any, in the correct use of the pulse oximeter and what may affect the readings. In order to test this theory, an audit was conducted on 50 staff within a large general hospital, comprising trained and untrained nurses and medical staff. Participants' responses to a questionnaire and to six clinical scenarios were analysed. Overall, there was a deficit in participants' knowledge on pulse oximetry. The answers given by the medical staff to the clinical scenarios showed no greater level of knowledge than many of the trained nurses. The recommendations made following this audit were to improve the education and training of all staff in the understanding of this technique.
The objective of this study was to investigate the effect of lying and sitting positions on urodynamic parameters and diagnoses. This prospective study was carried out on 96 women with urinary incontinence who underwent urodynamic assessment. Cystometry was performed both in the lying and sitting positions. For filling cystometry, we infused normal saline at a rate of 50 ml/min. All the results were entered on the urodynamic database and were analysed using Minitab software release 13.30. Mean age was 49 (20-84) years. Sixty-four (67%) women complained of mixed incontinence, 16 (17%) of urgency alone, eight (8%) of stress incontinence and eight (8%) of urgency and urge incontinence. Two (2%) showed stress incontinence by lying cystometry, and 53 (55%) by sitting cystometry. During lying nine (9%) demonstrated detrusor overactivity, while 53 (55%) demonstrated detrusor overactivity in sitting position. No case of mixed incontinence was diagnosed by lying cystometry but 17 (18%) cases were detected by sitting cystometry. This study explains the higher detection rate of stress incontinence, detrusor overactivity and mixed incontinence by cystometry in sitting position. Therefore, we recommend that sitting posture is preferred over lying position for performing cystometry.
Foot care is an integral part of a patient's daily hygiene requirements, yet the authors have found it to be an area often neglected by nurses. Foot and toenail problems present a considerable challenge to nurses in all healthcare settings, especially for patients with diabetes. However, patients without diabetes also suffer from minor foot abnormalities or injuries that might have been preventable. One acute hospital ward has worked closely with the chiropody department to improve the nursing team's competence and confidence in foot hygiene assessment and toenail clipping and has, therefore, improved the patient experience during hospital admission. This article describes how the nursing team used education to improve the foot care services offered to patients.
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