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CRNA : the clinical forum for nurse anesthetists最新文献

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US Food and Drug Administration: adverse event reporting. 美国食品和药物管理局:不良事件报告。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1998-11-01
A A Graham
{"title":"US Food and Drug Administration: adverse event reporting.","authors":"A A Graham","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article reviews adverse event reports associated with anesthesia devices submitted to the US Food and Drug Administration during the period of August 15, 1896 to August 15, 1998. Cardiovascular, general surgical, and plastic surgical devices are the most frequently reported devices. Deaths are most frequently associated with cardiovascular, general hospital, and gastrourological devices. The most frequently reported failures associated with ventilators are failures of audio or visual alarm systems.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"9 4","pages":"135-8"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20774853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anesthetic drug interactions. Quarterly update. 麻醉药物的相互作用。每季度更新。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1998-11-01
M S McAuliffe, E A Hartshorn
{"title":"Anesthetic drug interactions. Quarterly update.","authors":"M S McAuliffe,&nbsp;E A Hartshorn","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"9 4","pages":"172-6"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20774857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The National Practitioner Data Bank: implications for nurse anesthetists. 国家从业人员数据库:对麻醉师护士的启示。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1998-11-01
M Kremer, M Faut-Callahan
{"title":"The National Practitioner Data Bank: implications for nurse anesthetists.","authors":"M Kremer,&nbsp;M Faut-Callahan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The National Practitioner Data Bank (NPDB), created by the 1986 Health Care Quality Improvement Act, has been in operation since 1990. Hospitals and other credentialing bodies must query the NPDB when granting and renewing privileges. The NPDB receives about 25,000 reports of adverse actions against health practitioners each year. The NPDB was designed to be a flagging system providing information to licensing or credentialing authorities who would further examine practitioner records. Its purpose is to ensure that decision makers have information that might not otherwise be readily available, especially in the case of incompetent practitioners who move from hospital to hospital or state to state. Access to NPDB information is a concern for consumers and providers alike. Only 2% of matched reports to the NPDB made a difference in hospital privileging decisions. A limitation of NPDB information is that malpractice payments recorded in the NPDB do not necessarily constitute a comprehensive and definitive reflection of actual health care incompetence. All health care providers need to be aware of the NPDB, its mission, potential impact on their ability to be credentialed, and proposed additional uses of its information.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"9 4","pages":"157-62"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20774855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Setting the record straight on nurse anesthesia and medical anesthesiology education. 明确护士麻醉和医学麻醉学教育的记录。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1998-11-01
I P Gunn
{"title":"Setting the record straight on nurse anesthesia and medical anesthesiology education.","authors":"I P Gunn","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The history, qualifications, capabilities, and legal status of nurse anesthetists in the United States have been perceived by organized anesthesiology as both a professional and economic threat to the medical specialty. Such threats often lead to turf battles in which groups try to seek public affirmation of their point of view through ongoing public and/or government relation debate and activism. Medicine, including anesthesiology, has used educational preparation of physician and nurse specialists as a favorite topic for such activism. In this nation's competitive environment, facts are often prone to distortion knowingly or unconsciously. This article is aimed at setting right the facts in the current debate used by the American Society of Anesthesiologists in regards to the comparative analysis of CRNA and anesthesiologist education. Because medicine most often uses length of education as a quality measure of that education, regardless of the validity of such arguments, this comparison is set within that framework. Unfortunately, it will not be the last work on this subject.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"9 4","pages":"163-71"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20774856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improving patient care by reporting problems with medical devices. 通过报告医疗设备问题来改善患者护理。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1998-11-01
G G White, M D Weick-Brady, S A Goldman, T P Gross, D L Kennedy, B S Lucas, K Merritt, C Naschinski
{"title":"Improving patient care by reporting problems with medical devices.","authors":"G G White,&nbsp;M D Weick-Brady,&nbsp;S A Goldman,&nbsp;T P Gross,&nbsp;D L Kennedy,&nbsp;B S Lucas,&nbsp;K Merritt,&nbsp;C Naschinski","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Healthcare practitioners are the primary users of medical devices for direct patient care. As such, they are in the best position to recognize problems that result from the use of medical devices. The outcome of a device-related adverse event or product problem, as with any other medical product, can be serious and result in illness injury, or even death. The sooner that FDA learns about a problem, the sooner the agency can take action to protect patient and user safety. Healthcare practitioners are major contributors to the knowledge base related to device use and safety through astute monitoring, rapid identification of device-related problems, and reporting these problems. An understanding of the voluntary and mandatory mechanism of reporting will ensure that device problems are reported appropriately and in a timely manner. As the primary users of medical equipment for direct patient care, health care professionals have the training and expertise to improve patient care by reporting actual and suspected problems with medical devices.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"9 4","pages":"139-56"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20774854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A guide to understanding informed consent. 了解知情同意的指南。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1998-11-01
B J Hartgerink, P McMullen, J P McDonough, E J McCarthy
{"title":"A guide to understanding informed consent.","authors":"B J Hartgerink,&nbsp;P McMullen,&nbsp;J P McDonough,&nbsp;E J McCarthy","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Anesthesia providers are expected to provide information to the patient during the preanesthesia interview that enables the patient to make informed choices. Adequate disclosure during the informed consent process ensures the equalization of the practitioner/patient relationship and the decision-making rights of the patient. Both certified registered nurse anesthetists (CRNAs) and anesthesiologists are not only legally required to provide information that will allow a patient to make an informed judgment about how to proceed with various anesthetic modalities but are also obligated by their standards of practice. This article informs the CRNA about the principles of informed consent so that they can better understand their role in the informed consent process.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"9 4","pages":"128-34"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20774852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evidence-based practice, research, peer review, and publication. 循证实践、研究、同行评审和出版。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1998-11-01
I P Gunn
{"title":"Evidence-based practice, research, peer review, and publication.","authors":"I P Gunn","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>For about a quarter of a century, concerns have been expressed about published biomedical research. It became more acute after some published research and broad dissemination was found fraudulent. With the emphasis now being placed on scientifically validated or evidence-based practice, it has become more imperative that clinical guidelines be based on credible information in our textbooks and research literature. Since the early 1990s, it has been found that much of the research in our electronic databases does not meet quality standards and often is irrelevant, calling into questions problems with peer review, including the selection and publication process of our journals. This column is devoted to calling attention to these problems not only to CRNAs and other researchers, but also to the consumers of research who often use it to make changes in their practice. It also calls attention to the CRNA community about the movement toward calls for greater accountability in practice, both as to quality and cost, from which the movement toward evidence-based practice, the identification and benchmarking of best practices, and the development and implementation of clinical practice guideline has evolved. To feel ownership in anesthesia-related clinical practice guidelines, CRNAs must become involved in their development and implementation.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"9 4","pages":"177-82"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20773968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effect of intrathecal and epidural narcotic analgesia on the length of labor. 鞘内和硬膜外麻醉镇痛对产程长短的影响。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1998-08-01
C M Cutbush, J P McDonough, K Clark, E J McCarthy
{"title":"The effect of intrathecal and epidural narcotic analgesia on the length of labor.","authors":"C M Cutbush,&nbsp;J P McDonough,&nbsp;K Clark,&nbsp;E J McCarthy","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A number of studies have shown conflicting results on the effect of epidural (EPI) analgesia on the length of labor. Combined spinal-epidural (CSE) and intrathecal analgesia (ITA) techniques have been used to provide pain relief for parturients, but currently there are few studies comparing EPI, CSE, and ITA techniques and their effect on the length of labor. Intrathecal opioids provide immediate pain relief for the parturient without autonomic, sensory, or motor blockade. The purpose of this retrospective study is to identify the effects of ITA on the length of labor compared with other regional anesthesia techniques. A total of 213 uncomplicated obstetric charts were reviewed in a 70-bed Air Force hospital that provided EPI, CSE, and ITA for obstetrical patients. The study consisted of the following four groups: (1) CSE (n = 76), (2) EPI(n = 41), (3) ITA (n = 49), and (4) no regional analgesia (NR) (n = 47). The results showed that the length of first-stage labor was statistically significantly less for those who received ITA compared with those who received CSE, EPI, and NR (P < .001). Second-stage labor was statistically significantly shorter for the NR group compared with the CSE and EPI groups (P < .01). No statistically significant difference was found between the length of second stage for ITA and NR groups. ITA analgesia shortened the first stage significantly in both primipara and multipara patients (P < .01). These results imply that the use of intrathecal opioids in the obstetrical patient does not prolong labor and seems to shorten the first stage of labor in both the primipara and multipara patients.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"9 3","pages":"106-12"},"PeriodicalIF":0.0,"publicationDate":"1998-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20774848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anesthetic drug interactions. Quarterly update. 麻醉药物的相互作用。每季度更新。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1998-08-01
M S McAuliffe, E A Hartshorn
{"title":"Anesthetic drug interactions. Quarterly update.","authors":"M S McAuliffe,&nbsp;E A Hartshorn","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"9 3","pages":"118-22"},"PeriodicalIF":0.0,"publicationDate":"1998-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20774850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pulmonary edema and hyponatremia during hysteroscopic resection of uterine fibroids: case report. 宫腔镜下子宫肌瘤切除术中肺水肿及低钠血症1例。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1998-08-01
S M Scott
{"title":"Pulmonary edema and hyponatremia during hysteroscopic resection of uterine fibroids: case report.","authors":"S M Scott","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hyponatremia and fluid overload--the so-called TURP Syndrome--is a rare but well-understood complication of endoscopic resection of the prostate caused by rapid absorption of irrigating fluids from venous sinuses opened during the surgery. A similar syndrome occurring during endoscopic resection of the uterine mucosa has been postulated but only rarely described. New equipment and surgical techniques have recently been developed that allow for more invasive and extensive hysteroscopic surgery, which will inevitably lead to an increased incidence of this complication. We report the occurrence of a case of acute pulmonary edema occurring intraoperatively during hysteroscopic surgery, complicated postoperatively by severe hyponatremia. Anatomic and physiological causes of this syndrome are discussed, and recommendations are offered for avoiding and treating this potentially lethal complication.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"9 3","pages":"113-7"},"PeriodicalIF":0.0,"publicationDate":"1998-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20774849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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