Introdução: flebite é um dos eventos adversos presente em grande parte das instituições de saúde podendo comprometer a assistência ao paciente. A compreensão do tema faz-se importante para que melhor possam ser trabalhadas estratégias de prevenção e para tanto, é imprescindível conhecer suas características e eventuais associações relacionadas ao seu aparecimento. O estudo teve como objetivo geral avaliar as características dos pacientes com flebites notificadas e características desses eventos adversos em um hospital de médio porte em Ribeirão Preto, São Paulo. Material e Método: trata-se de um estudo quantitativo, descritivo, exploratório, retrospectivo e transversal, aprovado pelo Comitê de Ética em Pesquisa da Escola de Enfermagem de Ribeirão Preto/USP com coleta de dados das notificações realizadas entre 2012 a 2014. Na instituição hospitalar em que o estudo foi desenvolvido, 373 pacientes apresentaram 436 episódios de flebites. Os dados foram coletados por meio de um instrumento tendo como fonte de consulta as fichas de notificação e prontuários eletrônicos dos pacientes. Resultados: a média de flebite em 2012 foi de 2,13%(±0,009), em 2013 de 2,91%(±0,010) e em 2014 de 1,84%(±0,008), inferiores a 5%, que é o aceitável; a idade média dos pacientes foi de 59,3 anos sendo 50,7% do sexo feminino e 82,8% de cor branca. A Pneumonia foi o diagnóstico que mais levou à internação e 49,6% dos pacientes tinham hipertensão. Ocorreram 436 flebites com destaque a um paciente em que ocorreram cinco flebites no período de 30 dias; a classificação da flebite com maior ocorrência foi a de grau 2 (45,4%), o calibre do cateter mais utilizado foi o 22 G (29,7%); o local mais utilizado para punção dos acessos venosos foi o membro superior esquerdo (53,4%); os profissionais que mais realizaram as punções foram auxiliares/técnicos de enfermagem (62,6%). Quanto aos medicamentos utilizados na vigência das flebites, 96,2% eram antibióticos; o tempo de permanência do cateter desde sua inserção até o momento em a flebite apareceu foi de 48 horas (31,1); 20,9% das flebites notificadas eram de punções realizadas em outros serviços, que não a instituição onde o estudo foi realizado. Ocorreu variação nos resultados de exames coletados anterior e posteriormente à ocorrência da flebite como Hemoglobina, Glóbulos Brancos, Proteína C Reativa e Plaquetas; no entanto, apenas os dois últimos apresentaram resultados estatisticamente significantes (p=0,0095 e p=0,0001 respectivamente). Observa-se resultado estatisticamente significante (p=0,0172) na associação da flebite de grau 2 com o cateter de calibre n°22 G. Conclusão: o estudo agrega conhecimentos à área da enfermagem e é o primeiro abordando este tema realizado na instituição hospitalar. Apesar de o numero de flebite ser menor que o aceitável pela literatura, é preciso empenho e dedicação para que esse índice diminua ainda mais, pois isso influencia diretamente na qualidade da assistência e na segurança do paciente / Introduction: phlebitis is one of the adverse events presented in most part of health institutions that can put assistance to patients in danger. The comprehension of this theme made of great importance for a better worked prevention strategy and therefore, it is vital to know its characteristics and casual associations related to its appearance. The study has as general objective evaluate the phlebitis patients´characteristics notified and these adverse events characteristics in a medium-sized hospital in Ribeirão Preto, São Paulo. Material and Method: it is about a quantitative, descriptive, exploratory, retrospective and transversal study, approved by the Ethical Committee in Research from Nursing School in Ribeirão Preto/USP with the notification data collection applied out between 2012 to 2014. At the hospital institution which the study was developed, 373 patients presented 436 phlebitis episodes. The data were collected through an instrument having as source the notification records and patients electronical handbooks. Results: the phlebitis average in 2012 was 2,13%(±0,009), in 2013 2,91%(±0,010) and in 2014 1,84%(±0,008), inferior to 5%, which is acceptable; the mean age patients was 59,3 years old being 50,7 female and 82,8% white skin. Pneumonia was the diagnosis that took patients to hospital admission and 49,6% of the patients had hypertension. 436 phlebitis occurred with emphasis to one patient that had five phlebitis within 30 days; the phlebitis classification with higher occurrence was of degree 2 (45,4%), the most used caliber catheter was 22 G (29,7%); the most used for vein puncture access was the left upper limb (53,4%); the professional who most performed vein puncture were assistants/technical nursing (32,6%). According to the medications used during phlebitis moments, 96,2% were antibiotics; the time spent for the catheter since its insertion until the moment that the phlebitis appeared was 48 hours (31,1); 20,9% of notified phlebitis were from other punctures applied in other services, which were not in the institution that the study was conducted. It occurred variation in the collected exam results before and after the phlebitis occurrence like hemoglobin, white blood cells, Reactive Protein C; therefore, only the two last ones presented significant statistically results (p=0,0095 and p=0,0001 respectively). It is observed significant statistically results (p= 0,0172) in association with phlebitis of degree 2 with the catheter of caliber number 22 G. Conclusion: the study adds knowledge to the area of nursing and it is the first approaching theme that has happened in the hospital institution. Despite the number of phlebitis being smaller than the acceptable by the literature, it is necessary effort and dedication to this index diminish even more, because of that it directly influences in the patient´s assistance quality and the patient´s security

Este estudo teve como objetivo avaliar a conduta do enfermeiro frente ao traumatismo de uretra ocasionado pela inserção do cateter uretral. Este estudo teve aprovação do Comitê de Ética em pesquisa da Escola de Enfermagem de Ribeirão Preto - Parecer 466/12 e foi realizado em um Hospital Universitário em duas etapas: na primeira etapa, descritiva, foi efetuada consulta ao sistema eletrônico do hospital que trata de notificações sobre eventos adversos dos pacientes. Nessa etapa foi utilizado instrumento de perguntas objetivas elaborado pelo próprio pesquisador. Na segunda, quase-experimental pós teste, foram coletados os dados relacionados a autoconfiança de enfermeiros, que participaram de cenário simulado de baixa fidelidade. Nessa etapa para obtenção dos dados foi aplicado um questionário de caracterização dos sujeitos e instrumento já validado, de autoconfiança na Assistência de Enfermagem à Retenção Urinária (EAAERU), a qual encontra-se dividida em cinco fatores: 1) \"Intervenções realizadas durante o cateterismo urinário e/ou em situações iatrogênicas\", 2) \"Intervenções prévias ao cateterismo urinário\", 3) \"Intervenções realizadas após o cateterismo urinário\"; 4) \"Comunicação, consentimento e preparo dos materiais para realização do cateterismo urinário\", e 5) \"Avaliação objetiva da RU\" (retenção urinária). Os dados da primeira etapa foram analisados por estatística descritiva e os dados da segunda etapa foram codificados e digitados duplamente em planilhas do aplicativo Excel®, exportados e analisados no programa SPSS (Statistical Package for Social Science) ®, versão 22.0, como a escala original. Os resultados demonstram que na primeira fase do estudo entre as 5300 notificações do serviço, apenas 27 (1,96%) estavam relacionadas a problemas urinários. Entre essas, cinco diretamente ao cateterismo urinário. Na segunda fase do estudo, a amostra foi composta por 53 enfermeiros, entre os quais a maior parte era do sexo feminino, com idade média de 36 anos, menos de dez anos de formação. Entre eles a maioria cursava ou já haviam cursado pós-graduação. Segundo os entrevistados todos 53 (100,0%) já realizaram o cateterismo urinário e 46 (86,8%) já vivenciaram dificuldades no procedimento. A maioria já avaliou trauma uretral ocasionado pela passagem do cateter. A conduta tomada nessa circunstância foi comunicar o fato e solicitar avaliação de outro profissional (médico e/ou outro enfermeiro). Após atividade simulada de trauma uretral, na avaliação da autoconfiança, a EAAERU demonstrou boa confiabilidade na sua aplicação (? 0,966). Os menores escores encontrados na autoconfiança dos profissionais estiveram relacionados aos fatores 1) \"Intervenções realizadas durante o cateterismo urinário e/ou em situações iatrogênicas\" e 5) \"Avaliação objetiva da RU\". Observou-se ainda associação positiva entre a autoconfiança e a frequência de realização do cateterismo urinário. Conclui-se que os traumas de uretra são comuns na prática clínica, porém pouco notificados. Com relação à autoconfiança na introdução do cateterismo urinário em que ocorrem situações de trauma de uretra há dificuldade na tomada de decisão e na avaliação objetiva da RU. Uma vez que o cateterismo é de competência do enfermeiro, são necessários programas e instrumentos que capacitem os profissionais para tais situações / This study aimed to evaluate the conduct of the nurse to the urethral trauma caused by the insertion of urethral catheter. This study was approved by the Ethics Committee in research of the College of Nursing in Ribeirão Preto - Opinion 466/12 and was performed in University Hospital in two stages: in the first stage, descriptive, a question was made on the hospital\'s electronic system, which deals with notifications about adverse events of patients. In this stage, it was used an instrument of objective questions elaborated by the researcher herself. In the second stage, quasi-experimental posttest study, the data related to self-confidence of nurses who participated in simulated low-fidelity scenario was collected. In this stage, to obtain the data, it was applied a characterization questionnaire of subjects and already validated instrument of Self-Confidence Scale of Nursing Care in Urinary Retention (EAAERU), which is divided in five factors: 1) \"Interventions performed during urinary catheterization and/or in iatrogenic situations\", 2) \"Prior interventions to performing urinary catheterization\", 3) \"Interventions performed for urinary catheters\"; 4) \"Communication, consent and preparation of materials for performing urinary catheterization\", and 5) \"Objective evaluation of the urinary retention\". The first stage\'s data were analyzed by descriptive statistic and the second stage\'s data were codified and double typed in spreadsheets in the Excel® app, exported and analyzed in the SPSS program (Statistical Package for Social Science)®, version 22.0, like the original scale. The results demonstrate that in the first stage of the study, among the 5300 notifications of service, only 27 (1,96%) were related to urinary problems. Among these, five directly related to urinary catheterization. In the second stage of the study, the sample was made by 53 nurses, among which most were women, with an average age of 36 years, less than ten years of formation. Among them, most were attending or had already attended postgraduate. According to the interviewers, all 53 (100,0%) had performed urinary catheterization and 46 (86,8%) had gone through trouble during the process. Most of them had evaluated urethral trauma caused by the introduction of the catheter. The conduct taken in this circumstance was to communicate the fact and request the evaluation of another professional (Doctor and/or another nurse). After simulated activity of the urethral trauma, in the self-confidence evaluation, EAAERU showed good reliability on its application (?=0,966). The lowest scores found in the professionals\' self-confidence were related to the factors 1) \"Interventions performed during urinary catheterization and/or in iatrogenic situations\" and 5) \"Objective evaluation of the urinary retention\". It was also observed positive association between the self-confidence and the performance of urethral catheterization. It is concluded that urethral traumas are common on clinical practice, however little notified. With regard to self-confidence to the introduction of urethral catheterization in which occur urethral trauma situations, there is difficulty in decision making and objective evaluation of the urinary retention. Once the catheterization is the nurse\'s responsibility, programs and tools are necessary to enable professionals in such situations

Esta revisão integrativa da literatura teve como objetivo identificar na literatura nacional e internacional, no período de 1992 a 2002, as publicações referentes à utilização de curativos para manutenção de cateter intravenoso periférico. Identificamos sete artigos científicos no banco de dados Medline por meio da utilização dos descritores “peripheral catheterization" e “dressing". Para o alcance dos objetivos utilizado-se um roteiro sistematizado de coleta de dados. A análise constituiu da categorização, ordenação e síntese dos dados. Os resultados demonstraram que quatro publicações foram obtidas no site de periódicos on line disponibilizado pela Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, seis foram realizadas por enfermeiros, cinco utilizaram como metodologia o desenho descritivo comparativo. As complicações locais foram as variáveis investigadas na maioria das publicações, dois estudos demonstraram redução na ocorrência de complicações locais durante a utilização do curativo transparente com dispositivo de segurança acoplado. As considerações acerca dos problemas metodológicos identificados nas publicações fizeram concluir que falta base suficiente para subsidiar a seleção do curativo para manutenção de cateter intravenoso periférico. / This whole review of literature has the main goal to identify national and international literature within 1992 and 2002, the used reports were the aids to keep on the venous peripheral catheterization. It was identified 7 scientific reports in Medline data basis using the description “peripheral catheterization" and “dressing". Reaching the goals it was used a standarded data collection. The outcomes showed that four reports were obtained from internet sites of Journals from Graduation and Personal Studies Coordination, six of them were from nurses, five of them used as methodology a comparative descriptive design . The local complications were the researched varieties in the most reports, two studies showed decreased local complications during the use of transparent aid as a close secure gadget. The considerations about the methodological problem identified in the reports leaded us to conclude that misses enough basis to help a selection from aid to maintenance peripheral intravenous peripheral catheterization.

nÃo hà / Os recursos computacionais no ensino de enfermagem sÃo uma realidade que tem se intensificado nos Ãltimos anos. A hipermÃdia educativa sobre punÃÃo venosa perifÃrica (PVP), utilizada neste estudo, trata-se de uma tecnologia da informaÃÃo e comunicaÃÃo (TIC) construÃda para auxiliar os estudantes de enfermagem nesta temÃtica. Dessa forma, percebendo a importÃncia das ferramentas educacionais no ensino de enfermagem, realizou-se o presente estudo com os seguintes objetivos: construir uma hipermÃdia educativa sobre punÃÃo venosa perifÃrica para auxiliar o ensino de enfermagem; validar com os especialistas os aspectos de conteÃdo e tÃcnicos da hipermÃdia educativa; e avaliar a apreensÃo do conhecimento dos acadÃmicos de enfermagem sobre punÃÃo venosa perifÃrica antes e apÃs utilizaÃÃo da hipermÃdia. Trata-se de uma pesquisa metodolÃgica, aplicada, de produÃÃo tecnolÃgica. Dentre as diferentes metodologias para o desenvolvimento da TIC em ambientes virtuais de aprendizagem, optou-se, neste estudo, pela metodologia de Galvis-Panqueva, devido a sua clareza e coesÃo com as finalidades e os objetivos da pesquisa. Assim, as cinco fases que compÃem esta pesquisa sÃo: anÃlise, desenho, desenvolvimento, avaliaÃÃo e administraÃÃo. Dentro destas etapas, o presente estudo contemplou a construÃÃo, validaÃÃo e avaliaÃÃo da hipermÃdia. Na anÃlise foi delimitado os objetivos, conteÃdo, pÃblico-alvo, o ambiente de estudo e a infraestrutura tecnolÃgica. Na fase do desenho foi determinado o ambiente, a estrutura de navegaÃÃo e a interface da hipermÃdia. O desenvolvimento consiste na materializaÃÃo de todo o desenho elaborado na fase anterior, sendo escolhidos os programas, como o Flash e Shockwave, para realizar os efeitos interativos e a seleÃÃo da linguagem de programaÃÃo. Realizadas as trÃs fases de construÃÃo da hipermÃdia, a mesma foi disponibilizada na plataforma SOLAR e em seguida passou pelo processo de validaÃÃo e depois pela avaliaÃÃo com estudantes de enfermagem. No processo de validaÃÃo, foram convidados de acordo com critÃrios prÃ-estabelecidos, vinte e dois especialistas de enfermagem e vinte dois de informÃtica para avaliar a hipermÃdia. Os especialistas de enfermagem avaliaram os objetivos, o conteÃdo, a relevÃncia e o ambiente, jà os especialistas em informÃtica avaliaram funcionalidade, usabilidade e eficiÃncia. ApÃs esta avaliaÃÃo os especialistas fizeram algumas sugestÃes com vistas a adequar o material educativo. Assim, depois de realizar as modificaÃÃes solicitadas a hipermÃdia tornou-se vÃlida. Em seguida, a mesma foi aplicada com 21 estudantes de enfermagem matriculados na disciplina de Enfermagem no Processo do Cuidar do Adulto II, no perÃodo de outubro de 2012, onde foi aplicado um prÃ-teste com dez questÃes objetivas referentes à PVP. Os estudantes realizaram o curso, por meio da hipermÃdia e apÃs o tÃrmino, responderam o pÃs-teste. Os achados encontrados nesta avaliaÃÃo revelaram resultados estatisticamente significantes, uma vez que apÃs o uso da hipermÃdia os alunos apresentaram maiores acertos e pontuaÃÃes no pÃs-teste sobre a temÃtica de PVP. Percebe-se que a utilizaÃÃo dessas tecnologias constitui uma ferramenta importante para a disseminaÃÃo de informaÃÃes sobre a temÃtica de punÃÃo venosa perifÃrica, alÃm de subsidiar o ensino de enfermagem com o uso da TIC dentro da academia, auxiliando o professor no aprendizado do aluno e fornecendo novas estratÃgias para complementar o ensino presencial. / The computing resources in nursing education is a reality that has intensified in recent years. The educational hypermedia on venipuncture (PVP), used in this study, it is an information technology and communication (ICT) built to assist nursing students in this subject. Thus, realizing the importance of educational tools in nursing education, was held this study with the following objectives: build a hypermedia educational about venipuncture to aid the teaching of nursing experts validate the content and technical aspects hypermedia educational, and evaluate the acquisition of knowledge of nursing students about venipuncture before and after use of hypermedia. This is a methodological research, applied production technology. Among the different methodologies for the development of ICT in virtual learning environments, we decided in this study, the methodology Galvis-Panqueva due to its clarity and cohesion with the purposes and objectives of the research. Thus, the five phases of this research are: analysis, design, development, evaluation and administration. Within these steps, this study included the construction, evaluation and validation of hypermedia. The analysis was limited objectives, content, target audience, the study environment and technology infrastructure. In the design phase was evaluated environment, interface and navigation structure of the hypermedia. The development consists in the materialization of any drawing prepared in the previous phase, being chosen programs like Flash and Shockwave, to perform the interactive effects and the selection of the programming language. Conducted three phases of construction of hypermedia, was released on the same platform SOLAR and then went through the evaluation process, which was divided into two stages: expert validation and evaluation for nursing students. In the validation process, were invited according to predetermined criteria, twenty-two skilled nursing and twenty two computer to evaluate hypermedia. The experts have made some suggestions in order to adapt the educational material. So after making the changes requested hypermedia became valid. Then, an assessment was made with nursing students, where we applied a pretest with ten objective questions regarding PVP. The students took the course through the hypermedia and after completion, answered the post-test. The findings of this evaluation revealed statistically significant results, since after the use of hypermedia students had higher scores on the successes and post-test on the subject of PVP. It is noticed that the use of these technologies is an important tool for the dissemination of information on the subject of venipuncture, in addition to supporting nursing education with the use of ICT within the academy, assisting the teacher in student learning and providing new strategies to complement classroom teaching.

Introdução: flebite é um dos eventos adversos presente em grande parte das instituições de saúde podendo comprometer a assistência ao paciente. A compreensão do tema faz-se importante para que melhor possam ser trabalhadas estratégias de prevenção e para tanto, é imprescindível conhecer suas características e eventuais associações relacionadas ao seu aparecimento. O estudo teve como objetivo geral avaliar as características dos pacientes com flebites notificadas e características desses eventos adversos em um hospital de médio porte em Ribeirão Preto, São Paulo. Material e Método: trata-se de um estudo quantitativo, descritivo, exploratório, retrospectivo e transversal, aprovado pelo Comitê de Ética em Pesquisa da Escola de Enfermagem de Ribeirão Preto/USP com coleta de dados das notificações realizadas entre 2012 a 2014. Na instituição hospitalar em que o estudo foi desenvolvido, 373 pacientes apresentaram 436 episódios de flebites. Os dados foram coletados por meio de um instrumento tendo como fonte de consulta as fichas de notificação e prontuários eletrônicos dos pacientes. Resultados: a média de flebite em 2012 foi de 2,13%(±0,009), em 2013 de 2,91%(±0,010) e em 2014 de 1,84%(±0,008), inferiores a 5%, que é o aceitável; a idade média dos pacientes foi de 59,3 anos sendo 50,7% do sexo feminino e 82,8% de cor branca. A Pneumonia foi o diagnóstico que mais levou à internação e 49,6% dos pacientes tinham hipertensão. Ocorreram 436 flebites com destaque a um paciente em que ocorreram cinco flebites no período de 30 dias; a classificação da flebite com maior ocorrência foi a de grau 2 (45,4%), o calibre do cateter mais utilizado foi o 22 G (29,7%); o local mais utilizado para punção dos acessos venosos foi o membro superior esquerdo (53,4%); os profissionais que mais realizaram as punções foram auxiliares/técnicos de enfermagem (62,6%). Quanto aos medicamentos utilizados na vigência das flebites, 96,2% eram antibióticos; o tempo de permanência do cateter desde sua inserção até o momento em a flebite apareceu foi de 48 horas (31,1); 20,9% das flebites notificadas eram de punções realizadas em outros serviços, que não a instituição onde o estudo foi realizado. Ocorreu variação nos resultados de exames coletados anterior e posteriormente à ocorrência da flebite como Hemoglobina, Glóbulos Brancos, Proteína C Reativa e Plaquetas; no entanto, apenas os dois últimos apresentaram resultados estatisticamente significantes (p=0,0095 e p=0,0001 respectivamente). Observa-se resultado estatisticamente significante (p=0,0172) na associação da flebite de grau 2 com o cateter de calibre n°22 G. Conclusão: o estudo agrega conhecimentos à área da enfermagem e é o primeiro abordando este tema realizado na instituição hospitalar. Apesar de o numero de flebite ser menor que o aceitável pela literatura, é preciso empenho e dedicação para que esse índice diminua ainda mais, pois isso influencia diretamente na qualidade da assistência e na segurança do paciente / Introduction: phlebitis is one of the adverse events presented in most part of health institutions that can put assistance to patients in danger. The comprehension of this theme made of great importance for a better worked prevention strategy and therefore, it is vital to know its characteristics and casual associations related to its appearance. The study has as general objective evaluate the phlebitis patients´characteristics notified and these adverse events characteristics in a medium-sized hospital in Ribeirão Preto, São Paulo. Material and Method: it is about a quantitative, descriptive, exploratory, retrospective and transversal study, approved by the Ethical Committee in Research from Nursing School in Ribeirão Preto/USP with the notification data collection applied out between 2012 to 2014. At the hospital institution which the study was developed, 373 patients presented 436 phlebitis episodes. The data were collected through an instrument having as source the notification records and patients electronical handbooks. Results: the phlebitis average in 2012 was 2,13%(±0,009), in 2013 2,91%(±0,010) and in 2014 1,84%(±0,008), inferior to 5%, which is acceptable; the mean age patients was 59,3 years old being 50,7 female and 82,8% white skin. Pneumonia was the diagnosis that took patients to hospital admission and 49,6% of the patients had hypertension. 436 phlebitis occurred with emphasis to one patient that had five phlebitis within 30 days; the phlebitis classification with higher occurrence was of degree 2 (45,4%), the most used caliber catheter was 22 G (29,7%); the most used for vein puncture access was the left upper limb (53,4%); the professional who most performed vein puncture were assistants/technical nursing (32,6%). According to the medications used during phlebitis moments, 96,2% were antibiotics; the time spent for the catheter since its insertion until the moment that the phlebitis appeared was 48 hours (31,1); 20,9% of notified phlebitis were from other punctures applied in other services, which were not in the institution that the study was conducted. It occurred variation in the collected exam results before and after the phlebitis occurrence like hemoglobin, white blood cells, Reactive Protein C; therefore, only the two last ones presented significant statistically results (p=0,0095 and p=0,0001 respectively). It is observed significant statistically results (p= 0,0172) in association with phlebitis of degree 2 with the catheter of caliber number 22 G. Conclusion: the study adds knowledge to the area of nursing and it is the first approaching theme that has happened in the hospital institution. Despite the number of phlebitis being smaller than the acceptable by the literature, it is necessary effort and dedication to this index diminish even more, because of that it directly influences in the patient´s assistance quality and the patient´s security

"March 2003" Includes bibliographical references (leaves 61-68). Appendices: Publications arising from the research portfolio. 1. Conducting a systematic review -- 2. The effectiveness of mechanical compression devices in attaining hemostasis after removal of a femoral sheath following femoral artery cannulation for cardiac interventional procedures : a systematic review -- 3. Effectiveness of mechanical compression devices in attaining hemostasis after femoral sheath removal Contains three separate research projects, presented as separate reports, but all related to one area of interest - interventional cardiology. Seeks to identify effective femoral sheath removal practices after interventional cardiac procedures and determine patient's perceptions of the education prior to and after interventional procedures.

"March 2003" / Includes bibliographical references (leaves 61-68). / 1 v. (various pagings) : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Contains three separate research projects, presented as separate reports, but all related to one area of interest - interventional cardiology. Seeks to identify effective femoral sheath removal practices after interventional cardiac procedures and determine patient's perceptions of the education prior to and after interventional procedures. / Thesis (D.Nurs.Sc.)--University of Adelaide, Dept. of Clinical Nursing, 2003

Postoperative urinary retention (PUR) is a common problem seen after surgery, particularly after orthopedic surgery. There has been a great deal of research done surrounding the causes of PUR and the optimal treatment for PUR, all with conflicting results. Little research has been done with orthopedic nurses to find out how they actually treat PUR, and on what information they base those treatment decisions. Evidence-based practice has been gaining popularity recently and highlights the need for nurses to make treatment decisions based on sound research, patient preferences, clinical expertise, and taking into consideration health care resources and the clinical setting (DiCenso, Ciliska, & Guyatt, 2005). This study investigated nurses' views on the definition of PUR, how they assessed for PUR, how they treated PUR and what they based their treatment decisions on. Ten nurses who worked on orthopedic units were interviewed using a semi-structured format consisting of four questions. The interviews were recorded and then transcribed verbatim by the student researcher. Qualitative description, as described by Sandelowski (2000), was used to analyze data. All nurses defined PUR fairly similarly. Various contributing factors for PUR were mentioned, some that were studied in the literature, and some that were not. Each nurse had a slightly different way of treating PUR, and 'ward routine' was also described differently. Study results point to a need for more research and education in the area of PUR so that all nurses are treating PUR in the same manner based on the same sound knowledge base.

Steerable catheters are routinely deployed in the treatment of cardiac arrhythmias. During invasive electrophysiology studies, the catheter handle is manipulated by an interventionalist to guide the catheter's distal section toward endocardium for pacing and ablation. Catheter manipulation requires dexterity and experience, and exposes the interventionalist to ionizing radiation. Through the course of this research, a platform was developed to assist and enhance the navigation of the catheter inside the cardiac chambers. This robotic platform replaces the interventionalist's hand in catheter manipulation and provides the option to force the catheter tip in arbitrary directions using a 3D input device or to automatically navigate the catheter to desired positions within a cardiac chamber by commanding the software to do so. To accomplish catheter navigation, the catheter was modeled as a continuum manipulator, and utilizing robot kinematics, catheter tip position control was designed and implemented. An electromagnetic tracking system was utilized to measure the position and orientation of two key points in catheter model, for position feedback to the control system. A software platform was developed to implement the navigation and control strategies and to interface with the robot, the 3D input device and the tracking system. The catheter modeling was validated through in-vitro experiments with a static phantom, and in-vivo experiments on three live swines. The feasibility of automatic navigation was also veri ed by navigating to three landmarks in the beating heart of swine subjects, and comparing their performance with that of an experienced interventionalist using quasi biplane fluoroscopy. The platform realizes automatic, assisted, and motorized navigation under the interventionalist's control, thus reducing the dependence of successful navigation on the dexterity and manipulation skills of the interventionalist, and providing a means to reduce the exposure to X-ray radiation. Upon further development, the platform could be adopted for human deployment.

Postoperative urinary retention (PUR) is a common problem seen after surgery, particularly after orthopedic surgery. There has been a great deal of research done surrounding the causes of PUR and the optimal treatment for PUR, all with conflicting results. Little research has been done with orthopedic nurses to find out how they actually treat PUR, and on what information they base those treatment decisions. Evidence-based practice has been gaining popularity recently and highlights the need for nurses to make treatment decisions based on sound research, patient preferences, clinical expertise, and taking into consideration health care resources and the clinical setting (DiCenso, Ciliska, & Guyatt, 2005). This study investigated nurses' views on the definition of PUR, how they assessed for PUR, how they treated PUR and what they based their treatment decisions on. Ten nurses who worked on orthopedic units were interviewed using a semi-structured format consisting of four questions. The interviews were recorded and then transcribed verbatim by the student researcher. Qualitative description, as described by Sandelowski (2000), was used to analyze data. All nurses defined PUR fairly similarly. Various contributing factors for PUR were mentioned, some that were studied in the literature, and some that were not. Each nurse had a slightly different way of treating PUR, and 'ward routine' was also described differently. Study results point to a need for more research and education in the area of PUR so that all nurses are treating PUR in the same manner based on the same sound knowledge base.