Waughstout3935
Conclusions The reported non-significant differences in DPOAEs in individuals with tinnitus and/or hyperacusis do not support a peripheral mechanism or an interaction between peripheral and central mechanisms underlying tinnitus or hyperacusis. Our findings, however, suggest the need to assess basal cochlear function (e.g. EHF thresholds) for a better understanding of differences in DPOAE measures in tinnitus and/or hyperacusis.Objective The purpose of this study was to explore whether self-reported mental wellbeing (anxiety, depression and loneliness) in audiologists has changed over the course of the COVID-19 pandemic and to examine possible factors contributing to audiologists' current state of mental wellbeing.Design Two cross-sectional surveys were distributed at two different time points during the COVID-19 pandemic screening for psychological distress (PHQ-4 anxiety and depression) and loneliness (UCLA-3).Study sample 117 audiologists from around the world.Results Findings demonstrated that over the course of the COVID-19 pandemic audiologists' levels of depression decreased, levels of anxiety were low and stable, whilst levels of loneliness were stable and high. Younger age was associated with lower levels of mental well-being. Responses to open text questions suggests that audiologists could be supported through development of clear and consistent guidelines on COVID-19 workplace restrictions, allowing for more workplace flexibility and providing mental health support through employee assistance programs.Conclusions The rates of anxiety, depression and loneliness observed highlight the continued need for mental health and workplace interventions to support audiologists throughout the COVID-19 pandemic and the subsequent recovery period.
Peripheral venous catheters (PVCs) are the most common invasive route for the rapid administration of medication and fluids. The care of PVC sites after cannulation can pose challenges depending on nurses' level of knowledge and practice.
To transfer nurses' knowledge into practice on preventing common local complications of intravenous (IV) therapy.
A quasi-experimental study was undertaken.
A convenience sample of nurses from surgical and medical wards of a university hospital (
=64) was used. Pre- and post-education intervention levels of nurses' knowledge, practice and maintenance of PVCs, and the use of a visual infusion phlebitis scale to identify potential complications were assessed.
The effectiveness of the course was statistically significant for all three parameters (
<0.001).
The study highlighted the importance of ongoing education based on the latest available evidence to enable nurses to improve their knowledge and clinical practice with regard to PVC care and associated complications.
The study highlighted the importance of ongoing education based on the latest available evidence to enable nurses to improve their knowledge and clinical practice with regard to PVC care and associated complications.
This study aimed to identify the types of complications of peripheral intravenous catheters (PIVCs) in hospitalised children and possible risk factors for the development of extravasation, infiltration and phlebitis.
The study was conducted in the largest children's hospital in a region of Turkey, with a bed capacity of 354 and 1400 employees, which provides care only to paediatric patients aged from newborn to 18 years old. In this 5-month prospective study, the complications of PIVCs in hospitalised children and risk factors leading to the development of extravasation, infiltration and phlebitis were recorded. During morning and afternoon daily visits, the researcher examined catheter sites for complications and indications for removal.
The study covered 244 patients aged from 1 month to 17 years, 575 PIVCs and 1600 catheter days. The rates of infiltration and phlebitis observed in children with PIVCs were 8.7 % and 15.8% respectively. Logistic regression revealed that using 22- and 24-gauge catheters, hospitalisation in the surgery ward and continuous infusion were significant independent risk factors for the development of infiltration (
<0.001). Direct logistic regression revealed that age in months, hospitalisation in a surgery ward and placement of the catheter in the veins of the antecubital fossa were significant independent risk factors for the development of phlebitis (
<0.001).
Catheter size, hospitalisation in the surgery ward and continuous infusion contributed to the development of infiltration. Age, hospitalisation in the surgery ward and catheter placement in the antecubital vein contributed to the development of phlebitis.
Catheter size, hospitalisation in the surgery ward and continuous infusion contributed to the development of infiltration. Age, hospitalisation in the surgery ward and catheter placement in the antecubital vein contributed to the development of phlebitis.Indwelling medical devices, including vascular access and urinary catheters, pose a risk for infection, and therefore daily assessment and consideration of their continued need is a patient safety priority. The I-DECIDED® device assessment and decision tool is an evidence-based checklist, designed to improve the assessment, care and timely removal of invasive devices in acute hospitalized patients. This paper explains each step of the tool, with rationale for inclusion.John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses patient safety in the light of the recently published Ockenden report.This article discusses the implementation and development of a centralised immuno-oncology service. As the indications and licensing of oncological immune checkpoint inhibitors (ICIs) expanded rapidly, they brought with them increasing challenges. this website The article evaluates the impact of an immuno-oncology service, focusing on the following areas admission rates due to immune-related adverse events (irAEs), number of bed days occupied due to immunotherapy toxicity and the incidence of Grade 3 and 4 (severe and life-threatening) irAEs. The article will also give an overview of patients requiring acute and subsequent management of toxicity as a percentage of the overall patients commenced on immunotherapy. The ultimate aim of the article is to highlight the importance of toxicity management and the overall benefits of a immuno-oncology service. The article will also discuss the impact of COVID-19 on the immuno-oncology service, highlighting the ways in which the team has adapted to the current environment to ensure high standards of patient care have been maintained.
Peristomal skin complications (PSCs) are frequently reported postoperative complications. PSCs can present visibly or as symptoms such as pain, itching or burning sensations.
To develop a new tool that can capture a range of sensation symptoms together with visible complications and an objective assessment of discolouration in the peristomal area.
Consensus from qualitative interviews with health professionals and people with an ostomy, and input from expert panels, formed the basis of a patient-reported outcome (PRO) questionnaire. A decision tree model was used to define a combined score including PRO and objectively assessed discolouration area.
Six elements were included in the PRO questionnaire and four health states representing different severity levels of the peristomal skin were defined.
The Ostomy Skin Tool 2.0 is a sensitive tool that can be used to follow changes in the peristomal skin on a regular basis and thereby help prevent severe PSCs.
The Ostomy Skin Tool 2.0 is a sensitive tool that can be used to follow changes in the peristomal skin on a regular basis and thereby help prevent severe PSCs.
Intravenous therapy-related injury, its prevention, and treatment are ubiquitous topics of interest among neonatal clinicians and practitioners. This is due to the economic costs, reputational censure, and patents' wellbeing concerns coupled with the possibility of potentially avoidable serious and life-long harm occurring in this vulnerable patient population.
A term infant receiving a hypertonic dextrose infusion for the management of hypoglycemia developed a fulminating extravasation shortly after commencement of the infusion. This complication developed without notification of infusion pump pressure changes pertaining to a change in blood vessel compliance or early warning of infiltration by the optical sensor site monitoring technology (ivWatch®) in use. The injury was extensive and treated with a hyaluronidase/saline mix subcutaneously injected into the extravasation site using established techniques. Over a period of 2 weeks, the initially deep wound healed successfully without further incident, and complication rates have been reported to be as high as 75% Peripheral IV infiltration and extravasation (PIVIE) is implicated in up to 65% of IV-related complications PIVIE injury has the potential to cause serious harm Prompt recognition and timely appropriate intervention can mitigate many of these risks Adhering to the 5Rs for vascular access optimizes infusion therapy and potentially reduces complications.
During the first wave of the COVID-19 pandemic in the UK, south London had the highest number of COVID-19 patients admitted to critical care. At one hospital, staff being redeployed to critical care were invited to attend an orientation to critical care workshop.
To carry out a service evaluation of the training outcomes from rapidly redeployed staff who completed the workshop during the first wave of the COVID-19 pandemic (March-July 2020).
Two stages were used, the first was a post-workshop evaluation questionnaire completed immediately after the training, with the second involving a single centre e-survey questionnaire two months later.
In total 131 health professionals attended the workshop, and 124 (95%) post-course evaluations were completed. Some 116 staff were contacted for the e-survey, with a response rate of 34% (n=40). Overall, the training was well evaluated. Of the 40 respondents, 70% (n=28) had volunteered, but only just over half (n=21, 52%) went on to work in critical care.
This article describes the organisational response of one NHS acute hospital to the unprecedented challenges that arose from the COVID-19 pandemic. The service evaluation identified the importance of a pedagogical approach, which not only delivered clinical content, but also allayed anxiety for health professionals preparing to work in a new environment.
This article describes the organisational response of one NHS acute hospital to the unprecedented challenges that arose from the COVID-19 pandemic. The service evaluation identified the importance of a pedagogical approach, which not only delivered clinical content, but also allayed anxiety for health professionals preparing to work in a new environment.
To explore trainee and qualified advanced practitioner learning experiences, how training has prepared learners for clinical practice and role transition. Evaluation of a multidisciplinary learning approach was sought, identifying its impact on developing collaborative learning and working partnerships.
A small-scale, mixed-methods cross-sectional study was used to gather descriptive data. Convenience sampling was used with two groups trainees and qualified advanced (paediatric) nurse practitioners/advanced clinical practitioners (ANPs/ACPs). All participants had completed or were undertaking master's level training. An anonymous, voluntary online survey was used to gather quantitative and qualitative data reflecting participant learning experiences. Evaluation research methodologies and their application were examined through exploration of three advanced practice frameworks and a well-established framework for evaluation of training.
Overall, responses indicate positive learning experiences, and that current and previous ANP/ACP training in the UK does adequately prepare trainees for practice.
