Zobrazení zdroje stránky Hermannmcintyre4167

Guidelines recommend statin therapy for all patients with peripheral artery disease (PAD) due to the increased risk of adverse cardiovascular events. A lack of adherence to these guidelines was identified at a vascular clinic located in the southeastern United States. The aim of this nurse practitioner-led quality improvement project was to increase the percentage of patients with lower extremity PAD who were prescribed a statin medication at this clinic. Baseline data were obtained via a chart review. Using the Plan-Do-Study-Act (PDSA) model, a paper tool depicting an evidence-based algorithm was implemented in the clinic for 6 weeks to increase awareness of guidelines (PDSA cycle 1). Next, an electronic pop-up reminder was implemented in the electronic health record for the following 6 weeks (PDSA cycle 2). Data were collected throughout the process and analyzed to determine if either intervention increased the number of patients with PAD who were prescribed a statin medication. Baseline data revealed only 54.16% of patients were on a statin medication. After PDSA cycle 1, an average of 70.8% of patients were on a statin medication. PDSA cycle 2 revealed an average of 73.3% of patients were taking a statin medication. ANOVA was conducted and showed statistical significance between the groups (P&nbsp;=&nbsp;.003). There was statistical significance between baseline and implementation of the algorithm and baseline and implementation of the pop-up, but not between the 2 interventions. These findings are consistent with research suggesting algorithms and electronic reminders may increase medical staff awareness of guidelines. Standardization of these interventions enhanced provider adherence to guidelines and ultimately improved patient outcomes. BACKGROUND Different methods are available for the closure of the femoral artery after catheterization. The present study aimed at comparing the effect of manual compression (MC) and closure pad (CP) on vascular complications (hematoma and bleeding) of coronary angiography. METHODS In the current clinical trial, a total of 238 patients who were candidates for angiography were randomly assigned to the MC and CP groups. In the MC group, after removal of the arterial sheath, the arterial puncture site was manually compressed for 5-10&nbsp;minutes and hemostasis was achieved. In the CP group, after removal of the arterial sheath, the arterial puncture site was first manually compressed for 5-10&nbsp;minutes and initial coagulation was achieved. Then, to continue the coagulation process, a CP was attached to the artery puncture site. [https://www.selleckchem.com/products/ki696.html KI696 supplier] Postangiography complications including bleeding and hematoma were monitored in both groups immediately and up to 24&nbsp;hours after hemostasis. Data were analyzed by SPSS-18 software. RESULTS After angiography, 7 (9.5%) and 5 (2.4%) patients had hematoma in the MC and CP groups, respectively; however, no significant difference was found between the groups. Rebleeding after hemostasis was observed in 2 (7.1%) patients in the MC group, but none of the subjects in the CP group had rebleeding. There was no significant difference in bleeding volume between the groups. CONCLUSION The results indicated the same efficacy of MC and CP methods in the prevention of postangiography vascular complications. Given the advantages of CP such as the possibility of changing the position in bed and increased physical comfort in the patient, this method is recommended for angiography and catheterization. Smoking tobacco and metabolic disorders are global epidemics associated with cardiovascular, immune, respiratory, and metabolic diseases. Cigarette smoking seems to affect metabolic disorders. However, the effect of water pipe (Wp), also called hookah, smoking duration on obesity and lipid profile is still a sparse. The present study examined the relationship of smoking Wp with body weight (Bw), body mass index (BMI), total cholesterol, low-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc), total cholesterol/HDLc, LDLc/HDLc, and triglycerides. Obesity, lipid profile, and smoking status were obtained from a total of 291 participants of which 147 smoked Wp. Smokers were divided into 3 groups smoked 20&nbsp;years (Wp3) (n&nbsp;=&nbsp;30). The ANCOVA revealed greater BMI and Bw and lipid profile measures in individuals smoking Wp vs never (P&nbsp; less then &nbsp;.01). Additional analysis revealed that Bw and BMI were greater in the women (n&nbsp;=&nbsp;11) with longer Wp smoking history (P&nbsp; less then &nbsp;.05) but not the men (n&nbsp;=&nbsp;19). In addition, Tc, LDLc, Tc/HDLc, and LDLc/HDLc levels were greater among the men smoking Wp for longer time (P&nbsp; less then &nbsp;.05), but not the women. In conclusion, the study found greater obesity and lipid profile in the adults smoked Wp vs never, especially the ones smoked for longer time. OBJECTIF La présente directive fournit des données probantes et des recommandations relativement à la surveillance fœtale en période intrapartum par rapport à son utilisation, à sa classification, à son interprétation, aux réactions du fournisseur de soins et à l'inscription des données de surveillance. Cette directive vise à fournir les renseignements qui peuvent potentiellement limiter le risque d'asphyxie du nouveau-né tout en maintenant les interventions obstétricales au plus bas taux possible. UTILISATEURS CONCERNéS Les membres de l'équipe de soins intrapartum, y compris, notamment, les obstétriciens, les médecins de famille, les sages-femmes, les infirmières et leurs apprenants. POPULATION CIBLE Femmes en période intrapartum. OPTIONS Toutes les méthodes d'évaluation de l'activité utérine et de surveillance de la fréquence cardiaque fœtale ont été prises en compte dans l'élaboration du présent document. RéSULTATS Les conséquences, bienfaits et risques des différentes méthodes de surveillance sur la variéravail Classification de la surveillance fœtale intrapartum Fréquence cardiaque maternelle Évaluation de la surveillance du bien-être fœtal à la phase active du deuxième stade du travail Réanimation intra-utérine Stimulation digitale du cuir chevelu fœtal Prélèvement de sang au cuir chevelu fœtal Gazométries du cordon ombilical Données à consigner Technologies de surveillance fœtale non recommandées à l'heure actuelle Formation en surveillance du bien-être fœtal.