Executive Summary Introduction Methodology Used to Prepare the Guideline Epidemiology Incidence Etiology Major Epidemiologic Points Pathogenesis Major Points for Pathogenesis Modifiable Risk Factors Intubation and Mechanical Ventilation Aspiration, Body Position, and Enteral Feeding Modulation of Colonization: Oral Antiseptics and Antibiotics Stress Bleeding Prophylaxis, Transfusion, and Glucose Control Major Points and Recommendations for Modifiable Risk Factors Diagnostic Testing Major Points and Recommendations for Diagnosis Diagnostic Strategies and Approaches Clinical Strategy Bacteriologic Strategy Recommended Diagnostic Strategy Major Points and Recommendations for Comparing Diagnostic Strategies Antibiotic Treatment of Hospital-acquired Pneumonia General Approach Initial Empiric Antibiotic Therapy Appropriate Antibiotic Selection and Adequate Dosing Local Instillation and Aerosolized Antibiotics Combination versus Monotherapy Duration of Therapy Major Points and Recommendations for Optimal Antibiotic Therapy Specific Antibiotic Regimens Antibiotic Heterogeneity and Antibiotic Cycling Response to Therapy Modification of Empiric Antibiotic Regimens Defining the Normal Pattern of Resolution Reasons for Deterioration or Nonresolution Evaluation of the Nonresponding Patient Major Points and Recommendations for Assessing Response to Therapy Suggested Performance Indicators

Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia the official statement of the American Thoracic Society and the Infectious Disease Society of America (特集 救急診療ガイドライン) -- (海外のガイドライン)

Statistical Methods for Health Care Research

Principles and Practice of Sleep Medicine

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Handbook Of Psychological Testing

Job satisfaction among hospital nurses revisited: A systematic review

Purpose To investigate: (1) relationships between job stress, recognition of nurses’ performance, job performance and intention to stay among hospital nurses; and (2) the buffering effect of recognition of staff performance on the ‘stress–intention to stay at work’ relationship.

Background  Workplace stress tremendously affects today’s workforce. Recognition of nurses’ performance needs further investigation to determine if it enhances the level of intention to stay at work and if it can buffer the negative effects of stress on nurses’ intention to stay at work.

Design and methods  The sample of the present study was a convenience one. It consisted of 206 Jordanian staff nurses who completed a structured questionnaire.

Results  The findings of the study indicated a direct and a buffering effect of recognition of nurses’ performance on job stress and the level of intention to stay at work.

Conclusion  The results of the study indicated the importance of recognition for outstanding performance as well as achievements.

Implications for nursing management  The results of this study support the need to focus on the implementation of recognition strategies in the workplace to reduce job stress and enhance retention.

Job stress, recognition, job performance and intention to stay at work among Jordanian hospital nurses

Purpose: To investigate the relationships between social support, job satisfaction and intent to stay among Jordanian hospital nurses, and to compare the findings between private and public hospitals.



Design:  A correlational descriptive survey was used to investigate these relationships among convenience samples of Jordanian nurses in public (n = 288) and private hospitals (n = 195).



Methods:  Data were collected using a set of questionnaires that included the McCloskey/Mueller Satisfaction Scale, the Social Support Scale, the McCain's Intent to Stay Scale and a demographic form.



Findings:  The results indicated that when the levels of social support and job satisfaction increased, intent to stay at work increased as well. Nurses with high levels of social support indicated high levels of job satisfaction. Nurses in private hospitals reported higher levels of satisfaction and intent to stay than nurses in public hospitals.



Conclusion:  Nurse administrators and managers need to (1) investigate on a regular basis the contributors to satisfaction, and (2) incorporate support systems in their organizations to promote satisfaction and retention.

Support, satisfaction and retention among Jordanian nurses in private and public hospitals.

Aims and objectives. To explore the information needs of Yemeni patients who have undergone coronary artery bypass graftsurgery before hospital discharges and to examine the differences in the patients’ learning needs according to age, gender, levelof education and working condition.Background. Postcoronary artery bypass graft (CABG) patients need more information before their discharge from the hospital.This need ofinformation must be assessed andprovided forthem before their discharge from hospital to helpthem withadequatecare and recovery at home.Design. A descriptive, correlational design.Methods. Data were collected from 120 CABG patients before their discharge from Al- Thawra Hospital, Sana’a, Yemen, byusing modiﬁed Cardiac Patients Learning Needs Inventory (CPLNI) instrument. The Statistical Package for the Social Scienceswas used to analyse the collected data.Results. The information about chest and leg wound care, medication information, other pertinent information and complica-tions were indicated to be the most valued by CABG patients prior to discharge. There was a statistically signiﬁcant differencebetween patients’ total learning needs according to their socio-demographic characteristics. Male patients needed more infor-mation than female patients (p =0AE004). Younger (p =0AE021) and middle-aged (p =0AE032) patients needed more informationthan older ones. Highly educated (p =0AE000) and school-level (p =0AE002) patients needed more information than those in theuneducated group. Working patients needed more information than non-working ones (p =0AE000).Conclusion. This study suggests that CABG patients have high information needs within 24–48 hours before hospital discharge.In addition, the results of this study showed that there are statistically signiﬁcant differences in patients’ learning needs accordingto their demographic characteristics.Relevance to clinical practice. Assessment of CABG patients’ information needs before their discharge from hospital helps indeveloping effective educational programme that will help these patients in their recovery at home.Key words: CABG surgery, learning needs, perceived information needs, Yemeni patients

https://eis.hu.edu.jo/deanshipfiles/pub104795693.pdf

Perceived learning needs of Yemeni patients after coronary artery bypass graft surgery

Aim. The purpose of this study was to assess rates of and risk factors for deep sternal wound infection after coronary arterybypass grafting surgery.Background. Deep sternal wound infection is one of the most devastating complications of cardiac surgery, resulting in multipleoperative and non-operative procedures and increased hospital costs.Design. A retrospective design using an existing coronary artery surgery database of adults (n = 206) who had undergonecoronary artery bypass grafting surgeries between January 2004–January 2006 at a university afﬁliated hospital, northernJordan was used.Method. Multiple logistic regression analyses were used to asses rates of and risk factors for deep sternal wound infection.Results. Deep sternal wound infection incidence rate was 22% of the total sample. Risk factors of deep sternal wound infectioninclude: (1) diabetes (OR = 0AE317, p =0AE048), (2) Obesity (OR = 0AE275, p =0AE011), (3) duration of surgery (OR = 4AE22,p =0AE032) and (4) use of intraaortic balloon pump (OR = 0AE033, p =0AE001).Conclusion. The proposed model provides a preliminary indication of risk factors placing coronary artery bypass graftingpatients at risk of DSWI. Further investigations and testing of the model are needed.Relevance to clinical practice. Determining patients who are at risk of developing deep sternal wound infection after cardiacsurgeries is the ﬁrst step towards its prevention.Key words: coronary artery bypass grafting, deep sternal wound infection, infection, Jordan, risk, wounds

Risk factors for deep sternal wound infections after cardiac surgery in Jordan.

Background Patients who undergo coronary artery bypass graft (CABG) surgery experience a wide spectrum of physical and psychological symptoms after surgery. Studies have shown that symptoms usually decline over time; however, some can persist up to months after discharge. Objectives This study aims to assess symptoms experienced by patients after CABG surgery and any associations with demographic variables. Methods A descriptive, cross-sectional design was used. A convenience sample of 100 Jordanian post-CABG surgery patients was selected from 5 hospitals in Jordan. Patients were surveyed using the Cardiac Symptom Survey. To examine the associations between the symptoms experienced and selected demographic variables, χ(2) analyses were used. Results Chest incisional pain (65%) was the most frequently perceived symptom by the participants. Leg swelling (60%) was also reported by a nearly equivalent number of respondents. Symptoms like fluttering (15%), angina (8%), and depression (3%) were reported by a handful of participants. Three symptoms (poor appetite, sleeping problem, and fatigue) had significant associations with demographic variables. Discussion The identification of frequently perceived symptoms among post-CABG patients enables health care providers to focus their assessments in identifying and alleviating them. The demographic associations identified facilitate nurses to forecast certain specific symptoms in targeted populations, like women are more prone to experience poor appetite and sleeping difficulties and strengthen these groups with strategies to prevent themselves from these distressing symptoms.

Ibtisam M. Al-Zaru

Papers

Job stress, recognition, job performance and intention to stay at work among Jordanian hospital nurses

Support, satisfaction and retention among Jordanian nurses in private and public hospitals.

Perceived learning needs of Yemeni patients after coronary artery bypass graft surgery

Risk factors for deep sternal wound infections after cardiac surgery in Jordan.

Symptoms Experienced by Jordanian Men and Women After Coronary Artery Bypass Graft Surgery.