Showing papers in "Gastroenterology Nursing in 1996"
2,050Â citations
TL;DR: This textbook highlights growth and development throughout the life span, emphasizing normal development as well as the specific problems and health promotion issues common to each stage.
Abstract: Health Promotion Throughout the Life Span-Carole Lium Edelman 2013-01-01 Up to date and easy to read, this textbook provides comprehensive coverage of all major concepts of health promotion and disease prevention. It highlights growth and development throughout the life span, emphasizing normal development as well as the specific problems and health promotion issues common to each stage. All population groups are addressed with separate chapters for individuals, families, and communities. -Provided by publisher.
52Â citations
TL;DR: In this paper, a book that is provided in better way and utterance will be expected by many peoples, even if a good reader or not, feeling to read this book will always appear when you find it. But, when you feel hard to find it as yours, what to do? Borrow to your friends and don't know when to give back it to her or him.
Abstract: Interestingly, health care ethics committees the next generation that you really wait for now is coming. It's significant to wait for the representative and beneficial books to read. Every book that is provided in better way and utterance will be expected by many peoples. Even you are a good reader or not, feeling to read this book will always appear when you find it. But, when you feel hard to find it as yours, what to do? Borrow to your friends and don't know when to give back it to her or him.
51Â citations
TL;DR: The Division of Gastroenterology and Nutrition at The Children's Hospital of Philadelphia now uses a less restrictive diet, one enema, and X-Prep to achieve effective bowel preparation for colonoscopy.
Abstract: Flexible fiberoptic colonoscopy is an established diagnostic procedure in the pediatric patient. The approach to the pediatric patient is, however, different from the approach to adults. Bowel preparation must be geared to the age, size, and clinical status of the patient. An effective, palatable, standardized bowel preparation has not been determined for the child undergoing a colonoscopy. This study systematically evaluated three components of the bowel preparation--cathartics, diet, and enema use. The bowel preparation of 140 children undergoing colonoscopy at The Children's Hospital of Philadelphia was evaluated. The effectiveness of the bowel preparation was evaluated by direct visualization during the colonoscopy as to the amount and consistency of the residual stool in the colon. Parents were interviewed to determine adherence to the instructions including tolerance of diet, cathartics, and enema administration. Equipment maintenance was also monitored. An effective bowel preparation was achieved in all groups. As a result of this study, the Division of Gastroenterology and Nutrition at The Children's Hospital of Philadelphia now uses a less restrictive diet, one enema, and X-Prep to achieve effective bowel preparation for colonoscopy.
36Â citations
TL;DR: This pilot study was undertaken to describe the experience of living with ulcerative colitis using a phenomenological approach and found the impact of the disease on the subjects' lives and provide insight into this devastating disease.
Abstract: This pilot study was undertaken to describe the experience of living with ulcerative colitis. Using a phenomenological approach, three subjects with diagnosed ulcerative colitis were interviewed and asked to describe what it was like to live with ulcerative colitis. Data from transcriptions of the audiotaped interviews were gathered and analyzed. Five major themes arose: the uncertainty surrounding exacerbations; the fear and humiliation surrounding stool incontinence; the desperate need to find successful treatment; the profound effect on family life, social life, and work; and, finally, the feeling of being controlled by the disease. Findings detail the impact of the disease on the subjects' lives and provide insight into this devastating disease. Implications for nursing practice and research are discussed.
33Â citations
TL;DR: A review of published research regarding issues influencing sexual health in IBD, including growth and development, body image, intimacy and sexual functioning, fertility, and pregnancy, is included in this article.
Abstract: Alterations in sexual health caused by inflammatory bowel disease (IBD) may affect quality of life and disease status. IBD usually strikes adolescents or young adults, who are also facing developmental milestones important to sexual health. Issues include growth and development, body image, intimacy and sexual functioning, fertility, and pregnancy. A review of published research regarding these issues, in addition to suggestions for nursing assessment and interventions, is included in this article. Nurses must offer sensitive support and suggestions for coping. Nurses must be aware of the issues influencing sexual health when providing total care to clients with IBD.
22Â citations
TL;DR: This case-control study was an initial step to determine whether an association exists between breast feeding, oral contraceptive use, smoking habits during pregnancy, and the incidence of Crohn's disease.
Abstract: This case-control study, which examines maternal perinatal characteristics and behaviors during pregnancy, was an initial step to determine whether an association exists between breast feeding, oral contraceptive use, smoking habits during pregnancy, and the incidence of Crohn's disease. The population studied was mothers whose children were diagnosed with Crohn's disease before the age of 22. Population controls were selected by each case mother, who solicited two friends or neighbors with a child of similar age. Case mothers differed significantly on the variables of allergies (p = .05) and family history of inflammatory bowel disease (p = .001). No significant differences were found regarding feeding, oral contraceptives, or smoking. Using a forward step-wise logistic regression method, only family history remained in the equation.
19Â citations
TL;DR: This research study evaluated the safety of nurse-assisted PEG procedures by comparing the complications of placement with those complications that occur when two physicians perform the procedure.
Abstract: Percutaneous endoscopic gastrostomy (PEG) procedures have become a common, nonsurgical approach to providing enteral access to patients who are otherwise unable to meet their nutritional needs by mouth. Historically, two physicians have been required to complete this procedure; the first performed the endoscopy while the second helped to position the PEG tube. As a result of constraints on physicians' time and availability, as well as increased medical costs, this process has changed in some settings where the procedure is accomplished by one physician who performs the endoscopy and directly observes a nurse who acts in the role of the second physician. This research study was designed to evaluate the safety of nurse-assisted PEG procedures by comparing the complications of placement (i.e., infection, hemorrhage, perforation, and ileus) with those complications that occur when two physicians perform the procedure. The current standard of care for placing PEG tube was followed. Results in this small sample show that nurse-assisted PEG procedures are as safe as when two physicians perform this procedure.
18Â citations
TL;DR: Nurse practitioners were found to be significantly more likely than physicians to perform assessment for eating disorders and primary care providers included two nurse practitioners, two physician assistants, and nine physicians.
Abstract: This study was designed to evaluate the differences in nutritional assessments when performed by nurse practitioners, physicians, and physician assistants. Complete patient histories and physical records were assessed with the focus on the detection and prevention of eating disorders in female adolescents. Data included medical records of 111 female adolescents from a family practice with three separate sites. Primary care providers included two nurse practitioners, two physician assistants, and nine physicians. The null hypothesis that there is no difference in assessments of nurse practitioners, physician assistants, and physicians was rejected. A significant difference was found in the assessments of nurse practitioners and physicians (t = 2.62; p = .01). Nurse practitioners were found to be significantly more likely than physicians to perform assessment for eating disorders.
18Â citations
TL;DR: Nursing care workers from medical/surgical units in two acute care hospitals were assigned to two experimental groups and a control group and learned to increase their knowledge of dysphagia, knowledge attention, and the number of dysphagic patients identified and referred.
Abstract: The 15 million Americans who experience some degree of dysphagia risk choking, airway obstruction, aspiration-related pulmonary disease, and/or death. These complications increase mortality, morbidity, length of hospitalization, and healthcare costs, but may be preventable through nursing intervention. Fifty-four nursing care workers (NCWs) from medical/surgical units in two acute care hospitals were assigned by convenience to two experimental groups and a control group. Experimental groups A and B participated in an educational program on dysphagia designed to increase their knowledge of dysphagia, knowledge attention, and the number of dysphagic patients identified and referred. Group B received deliberate reinforcement of program content over a 1-month period. The educational intervention had a significant effect on knowledge level and knowledge retention, immediately and at 1-month posttest in both experimental groups. NCWs applied what they learned to clinical practice as evidenced by an increase in the number of patients identified as being at risk for or experiencing dysphagia. Reinforcement of program content did not affect the outcomes. The study has implications for staff educators and nursing personnel who care for persons at risk for dysphagia.
16Â citations
TL;DR: Whether the patient's risk factors, intraoperative occurrences, and/or medications used during endoscopy should be used to determine the minimum length of stay postconscious sedation or whether a general policy can be used, as is currently practiced at many institutions is investigated.
Abstract: The aim of this study was to identify the best method for determining when to safely discharge the endoscopy patient; specifically, it was designed to determine whether the patient's risk factors, intraoperative occurrences, and/or medications used during endoscopy should be used to determine the minimum length of stay postconscious sedation or whether a general policy can be used, as is currently practiced at many institutions. Preoperative, intraoperative, and postoperative data were collected on a convenience sample of 405 adult ambulatory outpatients undergoing upper endoscopy and/or colonoscopy. Subjects were also interviewed by phone within 48 hours of discharge to assess postdischarge complications and their duration. Age predicted length of time in recovery, but only 2% of the variation in recovery time was predicted by the study variables. Intraprocedure occurrences predicted postprocedure occurrence. The implications of these and other findings are discussed in relation to nursing practice and future research.
TL;DR: Evidence suggests that a decrease in mortality from colorectal cancer is associated with regular screening by sigmoidoscopy in an average risk population, and as the population ages, more persons are eligible for coloreCTal cancer screening.
Abstract: According to the National Cancer Institute, 138,200 new cases and more than 55,000 deaths from colorectal cancer occurred in the U.S. in 1995. A high percentage of early cancers can be detected by screening asymptomatic persons older than age 50 with a digital rectal exam, fecal occult blood testing, and sigmoidoscopy. Evidence suggests that a decrease in mortality from colorectal cancer is associated with regular screening by sigmoidoscopy in an average risk population. As the population ages, more persons are eligible for colorectal cancer screening. Physician endoscopists are not available in all areas, and changes in reimbursement rates have caused some to discontinue this service. For these reasons, the Veterans Administration Medical Center in Buffalo, NY, developed a Colorectal Cancer Screening Program managed by a gastroenterology Clinical Nurse Specialist (CNS). Through study and supervision, the CNS has become proficient in the performance of 60-cm flexible sigmoidoscopic techniques and the diagnosis of multiple colon disorders, including sessile and pedunculated polyps, diverticulosis, tumors, hemorrhoids, and other conditions.
TL;DR: An overview of issues pertaining to health teaching for adults to improve nurses' effectiveness as health educators is presented and the complex interrelationship of concepts central to a comprehensive, systematic approach to patient and family education is discussed.
Abstract: Patient education is increasingly emphasized by professional and accrediting organizations as a means for maximizing wellness and reducing healthcare costs. In this article, the author presents an overview of issues pertaining to health teaching for adults to improve nurses' effectiveness as health educators. The complex interrelationship of concepts central to a comprehensive, systematic approach to patient and family education is discussed within a patient-centered psychosocial framework.
TL;DR: A two-phase quality assurance monitor was performed with a pediatric outpatient population to determine how well the current preparation of Fleet Phospho-Soda, Fleet enemas, and diet modification cleaned the colon.
Abstract: A two-phase quality assurance monitor was performed with a pediatric outpatient population to determine how well the current preparation of Fleet Phospho-Soda, Fleet enemas, and diet modification cleaned the colon. We studied 99 patients in Phase 1, implemented changes, and then studied 99 patients in Phase 2. Phase 2 found increasing age to be significantly related to decreasing cleanliness of the transverse colon, ascending colon, and cecum, and increasing weight was found to be significantly related to decreasing cleanliness of the cecum. Phase 2 also found the second enema to be significant for increasing cleanliness of the rectum.
TL;DR: The authors found that the nurses emphasized patient cooperation, preparation, and comfort; had observed few complications, and had difficulty describing quantitative aspects of enemas (e.g., amount of solution given, speed of administration).
Abstract: The enema has evolved through trial and error, not scientific investigation. Because little scientific base exists, the authors began their study of enemas by examining current nursing practice. They asked 24 experienced registered nurses to describe how they give enemas, and if they had seen any complications. Interviews were audiotaped, transcribed, and analyzed using qualitative analysis software. The authors found that the nurses emphasized patient cooperation, preparation, and comfort; had observed few complications, and had difficulty describing quantitative aspects of enemas (e.g., amount of solution given, speed of administration).
TL;DR: The ethical principles used by a family and a health team during the decision to terminate tube feeding and hydration for a patient and eventually the dying process, of their husband and father are illustrated.
Abstract: Facilitating the death of a loved one through the withdrawal of nutritional support is a difficult choice. This case study illustrates the ethical principles used by a family and a health team during the decision to terminate tube feeding and hydration for a patient. Patient autonomy, beneficence, justice, and professional integrity are discussed. Also addressed are use of ordinary versus extraordinary means of treatment, futility of treatment, and quality of life. Nursing interventions used to assist the family with their fears and concerns during the decision-making process, and eventually the dying process, of their husband and father are described.
TL;DR: The association of headaches, eye irritations, respiratory problems, shortness of breath, rashes, memory loss, mood swings, and fatigue with 2% alkaline glutaraldehyde exposure is supported.
Abstract: Disinfectant surveys from responding members of the American Society of Postanesthesia Nurses were divided into two groups based on whether or not they considered themselves to be exposed to disinfectants in their work environment. Their survey responses were then compared with those obtained previously from members of the Society of Gastroenterology Nurses and Associates, Inc., who were regularly exposed to 2% alkaline glutaraldehyde in the work setting. There were significant differences among the groups in the percentage of respondents who reported having headaches, eye irritations, respiratory problems, shortness of breath, rashes, memory loss, mood swings, and fatigue. These findings support the association of these complaints with 2% alkaline glutaraldehyde exposure. In contrast, there were no significant differences among the groups in the percentage of respondents who reported having asthma, rhinitis, chest pain, nausea, diarrhea, muscle/joint pain, visual disturbances, or dermatitis.
TL;DR: The significance of this finding is that bacterial infections can be treated and cured, offering hope to individuals with peptic ulcers, and a hoped-for vaccine to prevent gastric infections with H. pylori is presented.
Abstract: The identification of the gastric bacterium Helicobacter pylori was a significant advancement in the treatment of peptic ulcer disease. H. pylori infects the gastric mucosa and its eradication is associated with the prevention of ulcer recurrence. The significance of this finding is that bacterial infections can be treated and cured, offering hope to individuals with peptic ulcers. Characteristics of H. pylori and its putative role in ulcer formation are discussed. The recent challenge has been to identify a drug regimen that will effectively eradicate this organism inexpensively and conveniently, while not causing significant side effects. Current diagnostic methods and antimicrobial therapies for H. pylori are also presented. A look to future directions in therapies includes a hoped-for vaccine to prevent gastric infections with H. pylori.
TL;DR: This study examined issues related to the transmission of bloodborne pathogens in practice and found information regarding knowledge level, practices of staff in applying universal precautions, and availability of supplies and equipment.
Abstract: Occupational exposure of healthcare workers to bloodborne pathogens and the transmission of human immunodeficiency virus and hepatitis B virus warrant study. This study examined issues related to the transmission of bloodborne pathogens in practice. Findings provide information regarding knowledge level, practices of staff in applying universal precautions, and availability of supplies and equipment. The concerns of nurses along with content for educational programs and suggested approaches to education are outlined.
TL;DR: Results indicated that zero respondents reported gastric cancer in this sample of healthcare personnel, which was occupationally exposed to both endoscopic disinfectants and HP.
Abstract: Secondary data analysis of the Society of Gastroenterology Nurses and Associates Endoscopic Disinfectant Survey was undertaken to answer the question, "What was the prevalence of gastric cancer among endoscopy personnel who were routinely exposed to Helicobacter pylori (HP) in their work environment?" This large sample of healthcare personnel (4,001) was occupationally exposed to both endoscopic disinfectants and HP There is a known positive relationship between the prevalence of HP infection, gastritis, and gastric cancer Results indicated that zero respondents reported gastric cancer in this sample
TL;DR: This article focuses on viral hepatitis because of the potentially devastating consequences of this disease group to gastroenterology nurses and appropriate nursing interventions are discussed.
Abstract: This article focuses on viral hepatitis because of the potentially devastating consequences of this disease group to gastroenterology nurses. Recent landmark work has reaffirmed the high risk of occupational exposure to viral hepatitis and the need for inoculation of all healthcare workers. Gastroenterology nurses, by virtue of their professional activities, are at particular risk. The various forms of viral hepatitis are reviewed and appropriate nursing interventions are discussed in this article.
TL;DR: Several case studies are presented in this article, noting the patients' histories, indications for stent placement, and nursing care pre-, intra-, and postprocedure.
Abstract: Esophageal endoprostheses or stents have been used successfully for more than 100 years in patients with esophageal or gastroesophageal (GE) junction cancer. In recent years, many manufacturers have produced these stents in various styles and materials, but the most innovative design is the expandable wire mesh stent. At Virginia Mason Medical Center, The Schneider Wallstent (Minneapolis, MN) and the Wilson Cook Z stent (Winston-Salem, NC) have been placed in a series of patients with obstructing or fistulizing neoplasms of the esophagus, GE junction, stomach, lung, or mediastinum. The nursing care of these patients requires meticulous attention to airway maintenance and oral suction. Stents cannot be repositioned after total deployment; thus, the nurse plays an important role in assuring correct placement. During and after the endoscopy, the nurse must be alert to any signs of possible complications, including bleeding, perforation, dyspnea from tracheal compression, and stent malposition. Several case studies are presented in this article, noting the patients' histories, indications for stent placement, and nursing care pre-, intra-, and postprocedure.
TL;DR: In an effort to provide continuity of care, a project was undertaken to establish an organization-wide policy for the care of patients receiving CS.
Abstract: Conscious sedation (CS) is used in a variety of healthcare settings on a wide range of patients. The methods of monitoring patients during and after the administration of CS vary considerably from one setting to another. In an effort to provide continuity of care, a project was undertaken to establish an organization-wide policy for the care of patients receiving CS.