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Innovation in Nursing: A Concept Analysis

The healthcare industry has experienced a proliferation of innovations for enhancing the life expectancy, quality of life, diagnostic, treatment and caring options, as well as the efficiency and cost effectiveness of the healthcare systems. Information technology has also played a vital role in the innovation of nursing care. The term in nursing innovation is widely used throughout nursing and allied health literature; however, the meaning of the term is not clear. This paper is a report of an analysis of the concept of innovation in nursing and provides a greater understanding of innovation and its use in the nursing profession.

Stan odżywienia pacjentów Neurochirurgicznego Oddziału Intensywnej Opieki Medycznej

Neurosurgical patients present important metabolic alterations that trigger increased energy and protein expenditure. The clinical condition in neuro patients associated with the use of sedatives, steroids, barbiturates and muscle-relaxing drugs postpones the use of nutrients in these patients and, thus, complications, including infection and longer hospitalization, may occur. Weight loss, negative nitrogen balance and immune dysfunction constitute a characteristic response in neurosurgical patients. There is a strong relationship between adequate nutritional status and recovery from critical illness. Improved nutritional status is associated with positive clinical outcomes. The health care team, nurses in particular, play a major role in the management and maintenance of an optimal nutritional status in patients who are in the neurosurgical clinic. This compilation aims at highlighting the fact that inadequate nutrition is a serious problem which increases incidence of morbidity and mortality especially in neurosurgical patients. The article also emphasises the importance of nursing assessment. (JNNN 2017;6(1):33–38)

Effects of oral care with glutamine in preventing ventilator-associated pneumonia in neurosurgical intensive care unit patients.

PURPOSE The study was designed as a randomized, controlled, experimental study aiming to determine the effects of oral care with glutamine in preventing ventilator-associated pneumonia in patients admitted to neurosurgical intensive care unit. METHODS The universe consisted of patients who are admitted to neurosurgical intensive care unit between January 2014 and August 2015, while the sample consisted of 88 patients who fulfilled the inclusion criteria and were randomly selected. The study group received oral care with 5% glutamine, whereas the control group received oral care with 2% chlorhexidine gluconate solution. DATA COLLECTING TOOLS All date was acquired using Patient Information Form, Acute Physiological and Chronic Health Evaluation scale (APACHE II), Beck Oral Assessment Scale (BOAS), Mucosal Plaque Score (MPS) and Clinical Pulmonary Infection Score (CPIS). One-way ANOVA test was used for comparing parameters with normal distribution between groups along with descriptive statistical methods. Kruskal-Wallis Test was used for comparing parameters without normal distribution between groups. RESULTS In the control group, mean BOAS score was 9.33±1.8 mean MPS score was 3.68±0.87 and mean CPIS score was 4.07±1.78. In the study group, mean BOAS score was 10.16±2.78, mean MPS score was 3.93±1.04 and mean CPIS score was 3.78±2.25. There was no statistically significant difference in mean scores at 1st day, 3rd day, 5th day and discharge (p>0.05). However, BOAS, MPS, CPIS and APACHE II scores was significantly lower at discharge than 1st day in both groups. CONCLUSION There was no significant difference in using 5% glutamine or 2% chlorhexidine gluconate solution for oral care for the prevention of ventilator-associated pneumonia. Similar studies with bigger sample size and longer term should be conducted for better results.

The effect of nursing care protocol on the prevention of central venous catheter-related infections in neurosurgery intensive care unit

PURPOSE This clinical study was planned to determine the effect of Nursing Care Protocol on the prevention of central venous catheter-related infections in neurosurgery intensive care unit. METHOD The study was conducted between January 2012 and December 2013. The sampling consisted of 160 patients compatible with study inclusion criteria (80 protocol and 80 control patients). Routine care was applied to the control group while the protocol group received catheter care according to the protocol formed in accordance with the suggestions of the Centers for Disease Control and Prevention. The data were collected from Patient Information Form, Follow-Up Form, and APACHE II scores. RESULTS A significant difference existed between the two groups in terms of mean APACHE II scores on discharge (p<0.05) whereas no significant difference in terms of mean fever, number of leucocytes and lymphocytes, C-reactive protein, and days of catheter carriage (p<0.05). Hemoculture positivity was less in protocol group, and this difference was statistically significant (p<0.05). CONCLUSION The suggested nursing care protocol is significantly efficacious in the prevention of CVC-related infections. Training of healthcare workers on using this protocol is recommended.

Poważne powikłanie u osób z uszkodzonym rdzeniem kręgowym: neurogeniczna dysfunkcja pęcherza moczowego

The complications of neurogenic bladder which follows spinal cord injury include urinary infections, sepsis, hydronephrosis, urinary tract stones, structural deterioration of bladder and bladder cancers. If the care and treatment intended to prevent these complications are not performed, the quality of life and environmental and social compliance of the patient are declined, and it can result with serious mortality and morbidity. Therefore, rehabilitation of neurogenic bladder should begin immediately after the injury in individuals with spinal cord injury, the patient and his family should be informed and educated adequately and the patient should be followed up for a lifetime. With proper management, urinary continence can be safely achieved and renal deterioration can be effectively prevented. (JNNN 2015;4(1):35–39)