Objective: Several studies evaluated the effectiveness of the ventilator care bundle in reducing the occurrence of ventilator-associated pneumonia. The ventilator care bundle efficacy in early mechanical ventilation weaning has not been adequately assessed. The study aimed to investigate the weaning success among chronic obstructive pulmonary disease (COPD) patients following ventilator care bundle application.
Methods: This study is quasi-experimental, recruiting 80 mechanically ventilated COPD patients (40 patients for each bundle and control group). It was conducted at the respiratory intensive care units (ICUs) at Mansoura University Hospital, Egypt. Data were collected using a mechanically ventilated patient (MVP) assessment tool, a ventilator care bundle compliance checklist, and MVP evaluation tools based on the Burns’ Wean Assessment Program (BWAP) checklist and the patient’s ventilation indicators.
Results: The results revealed that almost 75% of the bundle group was successfully weaned from invasive mechanical ventilation at the first attempt of the spontaneous breathing trial compared with 32.5% of the control group. The ventilation duration and length of ICU stay were reduced in the bundle compared with the control group.
Conclusions: The bundle group demonstrated higher weaning scores than the control group. Therefore, we recommend the integration of the ventilator care bundle in the weaning trial of MVPs to accelerate weaning and reduce the duration of mechanical ventilation.
Due to the increasing number of breast cancer (BC) cases in Oman and the impact of the novel coronavirus disease 2019 (COVID-19) on bed situation in the hospital, a policy of early discharge (ED) with drain after BC surgery was initiated at one of the tertiary hospitals in Oman. The uniqueness of this policy is no home visit follow-up conducted after discharge and the main mode of communication was through social media account (Instagram media). This policy then was evaluated by conducting a quasi-experimental study using a survey with ten open and closed-ended questions, five questions to explore patient experience using a five-point Likert scale. A total of 41 female patients responded to the survey. Almost 96% of the participants stated being well informed about drain care pre- and post-surgery at home. 9% of the participants developed early sign of infection and was managed at out-patient clinics. Participants with bilateral drains expressed more pain than those with single drain. 90% stated satisfied being discharged with breast drain whereas 10% preferred to stay in the hospital until the drains were removed. This study found that the policy of ED with a drain after breast cancer (BC) surgery is practical and well-accepted by most patients. The role of breast nurse and presence of family and institutional support enhanced the success of the policy implementation. To optimize patient care, conducting a training program by breast nurse for nurses at local health centres about care management of patients with drain could improve care and enhance patient satisfaction.
Objective: Prenatal maternal stress is a known risk factor for preterm birth, low birth weight, and infant health problems and may have long-term impacts on the offspring. The study aimed to assess pandemic-related pregnancy stress among a group of Egyptian women during COVID-19 pandemic.
Methods: The study used a descriptive cross-sectional design on 100 pregnant women who were selected using the purposive sample technique. The study was conducted at antenatal clinics of the Obstetrics and Gynecology Department at Mansoura University Hospitals, Mansoura city, Dakahlia governorate, Egypt. Two tools were utilized for gathering data; a structured interviewing questionnaire was used to assess the socio-demographic and reproductive characteristics of the studied pregnant women and the Pandemic-Related Pregnancy Stress scale was used to assess pandemic-related pregnancy stress among the studied pregnant women.
Results: The study findings revealed that less than half of pregnant women during the COVID-19 pandemic reported elevated levels of stress related to feeling unprepared for childbirth and around three-quarters experienced high stress related to perinatal infection.
Conclusions: The study concluded that the studied pregnant women during the COVID-19 pandemic had high levels of stress related to inadequate preparation for childbirth and stress related to the potential for perinatal infection. In addition, infection stress was more prevalent than preparedness stress among the studied pregnant women. It is recommended to provide prenatal educational programs related to coping strategies during the pandemic.
Background: Establishing a symptom onset timeline for stroke patients is one of the essential aspects of thrombolytic therapy. Implementing an MRI protocol can potentially increase the rate of thrombolytic therapy and expand treatment to patients who would otherwise be excluded.
Objective: This project aimed to increase the rate of thrombolytic therapy by incorporating an additional layer of evaluation within the established acute stroke code process for patients with wake-up stroke (WUS) or unknown symptom onset stroke.
Methods: Patients 18 years of age and older who presented as WUS eligible for thrombolytic therapy underwent acute MRI. Patients with a diffusion weighted image and fluid attenuated inversion recovery mismatch (DWI-FLAIR Mismatch) on MRI were treated with thrombolytic therapy.
Results: Chi-square test of independence showed patients who underwent the MRI protocol (N = 35) had a higher proportion of alteplase (tissue plasminogen activator,tPA) treatment when compared to a similar sample (N = 44) from 2019 acute stoke logs; χ2 (1, N = 79) = 8.16, p = .006. Six patients received thrombolytic. Safety showed no symptomatic intracerebral hemorrhage (sICH) or deaths. Conclusions: Results of the project indicated an increased rate of thrombolytic treatment that was statistically significant.
Objective: The purpose of this study was to evaluate the effectiveness of advanced practice registered nurses (APRNs) with wound specialization on wound resolution and healthcare (HC) utilization for home health patients.
Methods: A quasi-experimental design with a convenience sample of 30 participants admitted to home health (HH) services compared to a retrospective chart review of 46 participants matched in terms of volume, wound type, wound size, gender, and age was used during the study. The APRN conducted a physical exam and history, obtained wound photography, developed a treatment plan, performed therapy, wrote orders for products and services, and provided a minimum of weekly follow-up visits. Healthcare utilization comprised time for healing, admits to a higher level of care, and amputations. Wound resolution was observed at 80% and 100% closure.
Results: The Intervention and Control Groups were comparable in terms of gender, wound type, age, and acuity, were similar regarding wounds per patient. Both groups achieved 80% volume, 80% area, and 100% wound resolution, regardless of wound types. The Intervention Group’s days to wound resolution was statistically significant for fewer days than the Control Group. This difference persisted after analysis of wound types within the groups. The Intervention Group had fewer acute care admits (10%) compared to the Control Group (50%), and the number of amputations was higher in the Control Group, with six amputations compared to only one in the Intervention Group.
Conclusions: Using APRNs with wound specialization improved patient outcomes, efficiency, and costs. The program should be evaluated for adoption and expansion. Further research into the impact of wound-specialized APRNs in the home setting is recommended.