Critically ill patients with acute renal failure who are receiving dialysis therapy may suffer from many complications that can be decreased by using bicarbonate dialysate during dialysis sessions. Aim: this study was carried out to compare between the hemodialized acute renal failure patientsusing bicarbonate versus acetate dialysate ondeveloping complications. Design: descriptive comparative designutilized in this study. Setting: This study was carried out at the kidney dialysisunit, Assiut University Hospital. Subjects Sixty adult male and female critically ill patients with acute renal failure who are admitted to the kidney dialysis unit (how many using bicarbonate and how many using acetate and how you selected them).Tool:"hemodialysis patient observational and monitoring tool" was used to monitor and record the personal and medical data needed for this study by the researcher.Methods: Interview, observation and reviewing patient`s records were utilized to collect data pertinent to the study. Each patient was monitored closely ten minutes before connection to the dialysis machine, during the dialysis session and ten minutes after disconnection, three times per week for two successive weeks. Results: The patients on the acetate group had experienced many problems (tachycardia, hypotension and dyspnea). There was a significant statistical difference between both groups with (p value=0.001). Conclusion: the group of patients on bicarbonate dialysate during dialysis sessions was found to experience lesser problems than acetate dialysis group.
Background: Pain is the most common reason due to which patients come to the emergency department and painful traumatic injuries account for a large portion of emergency department visits. Inadequately managed pain can lead to adverse physical and psychological patient outcomes. Because of the capricious nature of trauma pain, recognition and alleviation of pain, regular assessment and frequent adjustments in medications, dosages, and techniques should be a priority when treating the ill and injured patients. Aim of the study: to assess nurses' knowledge and practices regarding management of acute pain among injured persons at Kafr El Sheikh General Hospital. Research Design: A Descriptive exploratory research design was utilized in the current study. Research questions: a) What do emergency nurses know about management of acute pain among injured persons at Kafr El Skeikh general hospital? b) What are the emergency nurses' practices toward acute pain among injured persons at Kafr El Skeikh general hospital?Setting: The study was carried out at the emergency department in Kafr El sheikh general hospital. Sample: A purposive sample including nursing staff who were working in the emergency department at Kafr El Sheikh general Hospital and were willing to participate in this study(70 nurses).Tools of data collection; Tool 1:Knowledge assessment questionnaire sheet which consist of two parts(a)personal characteristics& background data.(b)Emergency nurses' knowledge regarding management of acute pain Tool 2: An observational checklist Results: (91.4%) of the study sample were females .As Well, (85.7%) of them were married .While (47.1%) of them were having technical nursing institute degree and (45.7%) of them got training courses in emergency courses, the highest mean scores related to causes of acute pain(0.4333 out of 1),all the study subjects had unsatisfactory general knowledge about acute pain and hundred percent of the studied sample were having an unsatisfactory practice level in relation to nursing management for acute pain Conclusion: considering the result of the present study and the available evidence it can be concluded that, hundred percent of the studied sample were having an unsatisfactory Knowledge practice level in relation to nursing management for acute pain. Recommendations: based on results of the present study can recommended Hospital decision makers create strategies to decrease work load on nurses and encourage inservices training programs for nurses included knowledge and skills for how to apply assessment and management of patients with acute pain.
Health outcomes are the main measure of critical care practice. Mortality during ICU stay has been most frequently used effects in clinical practice. So this study aims to assess profile criteria for patient admitted to general intensive care unit and to describe their outcomes. A descriptive research design was once used. Setting: study was carried out at General Intensive Care Unit at Assuit University Hospital, A convenience sample of all adult critically ill patients over a period of 12 months. Two main tools used, tool I: patient profile characteristic's sheet, Tool II: clinical outcomes assessment tool: Main results: of 302 patients were admitted to General ICU, there were 55.6% males and 44.4% females. Age group from 50-65 years account for 52.3% of total admission, the study showed that trauma cases account for 21.9% of all admission and it was the same as respiratory cause while the lowest was from Gynecological & obstetric, drowning and Hematological Disease 0.7%. Mortality rate was 52.3%.Conclusion: Majority of the studied patients at general intensive care unit were at a high risk of mortality with total mortality rate of 52.3 % more than half of death patients were aged from 50 -65 years and males. Recommendations: -Future identical studies should be carried to disclose standards for intensive care admissions
Background: Workplace violence toward nurses has increased, with severe consequences to professionals and their healthcare organizations. Violence towards nurses may have long-term consequences not only on nurses' personal lives and their ability to care for patients. Aim: To assess nurses' perception of workplace violence, and it's relation to their absenteeism. Research design: A descriptive correlational research design. Subjects: A convenience sample of staff nurses working in Elfkrea Hospital (N= 180). Setting: Elfkrea Hospital, Minia governorate, Egypt. Tools of data collection: included two tools; first tool Workplace violence Questionnaire; second Absenteeism Questionnaire. Results: the majority of staff nurses have been exposed to workplace violence, and minority of them have not been exposed to workplace violence. More than half of staff nurses have been instructed to report physical or verbal abuse regardless of the severity or harm to the direct manager and security. Most of the patients relative the main responsible for it followed by more than two-thirds of them were patients themselves, and the minority were the physician and charge staff nurses and more than three-quarters of the staff nurses said workplace violence can lead to absenteeism and more than half of them are sure that workplace violence can lead to retirement. Conclusion: The findings of this study revealed that positive weak correlation between workplace violence among the studied staff nurses and their absenteeism. Recommendations: Policies and legislation targeting violent acts should be instituted and developed, and a high percentage of staff nurses need training in violence management.
BACKGROUND In patients with High Grade Glioma (HGG), QoL and physical function decline with progressive disease (PD). Objective assessment of physical functioning is challenging as patients spend most of their time away from the hospital. Wearable technology allows measurement of objective, continuous activity data in a non-obtrusive manner. BrainWear is a phase II feasibility study, collecting longitudinal physical activity (PA) data from patients with primary and secondary brain tumours. MATERIAL AND METHODS All agreed to wear an Axivity AX3 triaxial accelerometer and completed the EORTC QLQ C30 and BN20, the Montreal Cognitive Assessment (MoCA) and Multidimensional fatigue inventory (MFI) questionnaires. Accelerometers were changed at 14-day intervals, and PRO questionnaires completed at pre-specified study intervals. Age-sex matched controls were identified from the UK Biobank 7-day accelerometer study. Raw accelerometer data was processed using UK Biobank accelerometer software and inclusion of high-quality wear time selected as ≥72 hours of data in a 7-day data collection and data in each 1-hour period of a 24-hour cycle over multiple days. We analysed variation in activity by patient demographics and treatment days. The wilcoxin-signed rank test was used to compare participant activity between radiotherapy treatment days and non-treatment days, mixed effects models were used to evaluate longitudinal changes in activity and we used k-means clustering to characterise clusters of PA behaviours. RESULTS We have collected 3458 days of accelerometer data from 42 HGG patients with a median age of 59, 80% of which has been classified as high quality. Patients >60 years spend more time doing moderate activity compared to those <60 years (52 vs 33 minutes/day, p=0.012), and there are significant differences in mean vector magnitude (17.12 vs 16.85 mg, p=0.013) and walking (91 vs 72 minutes/day) between radiotherapy and non-radiotherapy days. In patients having a 6-week RT course, time spent in daily moderate activity falls 4-fold between week 1 and the second week after RT completion (70 minutes to 16 minutes/day). Comparing HGG patients to healthy controls shows a significant difference in time spent across all activities (p<0.05). K-means clustering analysis shows three distinct clusters, with 87% of HGG patients falling into the very inactive or moderately active groups. CONCLUSION Digital remote health monitoring is feasible and acceptable with 80% of data classified as high-quality wear-time suggesting good patient adherence. Triaxial accelerometer data collection captures objective evidence of a significant reduction in moderate daily activity at the time of expected peak RT side-effects and patients walk almost 30% less on non-RT treatment days. HGG patients show significantly lower levels of activity compared to matched healthy controls.
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