skin-care-5.matches: skin care
Development and implementation of a nursing skin care protocol.

Kravitz R.

More hospitals are using skin ulcer protocols to standardize care for the purpose of enhancing skin ulcer healing and reducing costs. This article outlines the role of the ET nurse in facilitating the development of a nursing protocol specific to an institution's needs. It outlines development of a monitoring tool to assess compliance and discusses the impact such a process had on the nursing and medical staffs in one community teaching hospital.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8452919&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
Diarrhea in acquired immune deficiency syndrome (AIDS).

Anastasi JK.

Diarrhea is a common manifestation of HIV disease which most nurses will find themselves confronting at some point. It can be extremely debilitating, as well as causing psychological distress to patients. Treatment depends on etiology; it may be successful if the diarrhea is caused by a specific enteric pathogen or a specific medication the patient is taking. However, often the diarrhea cannot be resolved and treatment must be by supportive measures. Management has three components: diet, anti-diarrheal agents, and skin care. A multidisciplinary team provides the most effective approach for managing these complex, difficult cases.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8489686&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
Adhering to inpatient geriatric consultation recommendations.

Cefalu CA.

Department of Family Medicine/Providence Hospital, Georgetown University School of Medicine, Washington, DC, USA.

BACKGROUND: The purpose of this study was to evaluate the rate of and factors associated with attending physicians' adherence to geriatric consultation recommendations in an urban community hospital. METHODS: A retrospective review was performed of the charts of 47 patients referred for inpatient geriatric consultation over the previous 1 1/2-year period. Study variables included patient and attending physician demographics, length of stay in hospital before geriatric consultation, status of patient on discharge, level of expertise of consultant, number of diagnoses per patient, and types and number of recommendations per patient made by consultant and acted upon by attending physicians. RESULTS: The recommendations made included medical (23.4%), medication (28.6%), laboratory (15.8%), radiological (2.6%), nutritional (11.7%), psychosocial (7.7%), skin care (1.6%), rehabilitative (6.4%), and other (2.2%). The percentage of total recommendations acted upon was 55.5%. By multivariate analysis, decreasing length of time prior to consultation was statistically associated with referring physician adherence to consultation recommendations (P=.03). Slightly more than 40% of the variability in adherence was explained by this single variable. CONCLUSIONS: Inpatient geriatric consultations are aimed at providing a comprehensive assessment for attending physicians. Recommendations are acted upon more than 50% of the time. Physician adherence to recommendations does not appear to be dependent on patient or physician demographic variables, but to some extent, adherence is associated with less time in the hospital prior to consultation. This is a relatively new concept in hospital medicine.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8636677&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
Compliance with the Control of Substances Hazardous to Health Regulations (COSHH) 1988 and health and safety awareness in hairdressing establishments.

Palmer KT, Freegard J.

North Wiltshire District Council Department of Environmental Health, Chippenham, Wilts, UK.

Hairdressers are known commonly to suffer work-related skin problems. To explore the steps taken by employers and employees to prevent or control such problems, we visited 12 randomly selected high street hairdressing establishments in North Wiltshire and interviewed the proprietors and 43 of the employees by means of structured questionnaires. Relatively few of the establishments had taken any steps to comply with the statutory requirements of the Control of Substances Hazardous to Health (COSHH) Regulations 1988. Some premises lacked basic skin care facilities and employers often failed to provide hand care training and health monitoring. More than half of the employees had experienced work-related skin problems, typically dermatitis. Those with skin problems more commonly identified precautionary skin care measures; however, many employees could not identify desirable skin precautions when questioned. A fifth had never received skin care training. For the remainder the median elapsed interval since last trained exceeded 6 years. Only one establishment had a satisfactory skin care programme. Future efforts should be directed at training and influencing the attitudes of hairdressing employers.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8672794&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
Standardizing skin care across settings.

Brown DS, Small S, Jones D.

While healthcare providers are struggling to provide optimum patient care and health outcomes in a cost efficient manner, patients are demanding assurance that the care they receive offers the best chance for health improvement. The way to achieve the most effective and efficient treatments is through knowledge of current research and treatment options and standardized care. Resources are the AHCPR's Clinical Practice Guidelines on urinary incontinence and pressure ulcers in adults. Kaiser Permanente's Northern California Region created a Task Force to demonstrate nursing's contribution to positive patient outcomes, investigate and capture opportunities to participate in an interdisciplinary approach to measuring the effectiveness of patient care, and focus efforts on measurement, improvement, research, and development. Part of this effort was the conductance of a study which demonstrated that the absorbent product with the least expensive purchase price that had traditionally been used for incontinent patients was the most expensive product to use. The results of that study have been used, not only to improve purchase decisions, but also to teach nurses how theory, research, and practice are related to issues that concern caring for their patients.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8679049&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
Implementation of a comprehensive skin care program across care settings using the AHCPR pressure ulcer prevention and treatment guidelines.

Suntken G, Starr B, Ermer-Seltun J, Hopkins L, Preftakes D.

Healthcare professionals in the Central Midwest identified the need for a comprehensive skin care program for pressure ulcer prevention and treatment across care settings. A multidisciplinary team, representing acute, extended and home care, was formed to create a program for all three settings based upon the AHCPR pressure ulcer guidelines. The team performed literature reviews on which to base the development and use of tools, conducted prevalence studies, and developed educational approaches. Implementation of the program was tailored for each setting. Some of the approaches used were a skin care fair, quality studies, continuous quality improvement concepts, a "Product Book" and educational presentations. Outcomes include improvement of continuity of care across settings and the use of the Braden Scale and the NPUAP pressure ulcer staging system. The focus has turned toward patient outcomes. Professionals have a better understanding of the care that is provided by other disciplines. Referrals are made based upon decision trees. Appropriate resources are used. Other outcomes anticipated include a decrease in nosocomial pressure ulcers, shortened wound healing time, appropriate referral of unresponsive chronic wounds, decreased discrepancies in wound documentation, decreased length of stay, improved financial outcomes, and improved client knowledge and participation.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8703293&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
Emollients and photo(chemo)therapy: a call for caution.

Gabard B, Treffel P, Bieli E, Schwab S.

Department of Biopharmacy, Spirig Ltd., Egerkingen, Switzerland.

BACKGROUND: Emollients used for skin care, treatment of a disease or lubrication, before irradiation during the course of phototherapy or photochemotherapy, may significantly interfere with the transmission of UV light and may influence the outcome of the therapy. OBJECTIVE: These experiments should characterize and quantify the possible interactions of usual emollients with UV light transmission. METHOD: The method was an in vitro technique similar to the one already used for the determination of sun protection factors of topical sunscreen preparations. RESULTS: Among the products tested, two showed a significant photoprotection capable of interfering with the course of therapy. Oils enhanced UV light transmission significantly. CONCLUSIONS: Emollients may show significant interference with UV light transmission during phototherapy or photochemotherapy. The outcome and course of the therapy could thus be significantly modified.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8726639&dopt=Abstract skin, skin care, skin care medicine