Læknablaðið : fylgirit - 01.05.2002, Blaðsíða 36

ABSTRACTS / 33RD SNC & 2ND SCNN
Table I
Glucose mM/L Lactate mM/L Pyruvate P-M/L La/py ratio Glycerol jiM/L Glutamate jlM/L
Normal Mean 1.7 2.9 166 23 82 16
brain S.D. 0.9 0.9 47 4 44 16
Manifest Mean 0.1 8.9 31 458 573 381
ischemia S.D. 0.2 6.5 47 563 427 236
References:
1. Reinstrup P, Stáhl N, Hallström Á, Mellergárd P, Uski T, Ungerstedt U,
Nordström CH: Intracerebral microdialysis in clinical practice. Normal values
and variations during anaesthesia and neurosurgical operations. Neurosurgery.
47:701-710,2000
2. Stáhl N, Mellergárd P. Hallström Á. Ungerstedt U, Nordström CH: Intracerebral
microdialysis and bedside biochemical analysis in patients with fatal traumatic
brain lesions. Acta Anaesthesiol Scand. 45: 977-985,2001
3. Stáhl N. Ungerstedt U, Nordström CH: Brain energy metabolism during
controlled reduction of cerebral perfusion pressure in severe head injuries.
Intensive Care Med 27:1215-1223,2001
NURSING PLATFORM SESSION II
61 - Identifying Nursing Sensitive Patient Outcomes (NOC) in
neuro-rehabilitation at Landspitali - University Hospital in
lceland
Guðmundsdóttir E, Delaney C, Thoroddsen Á
Landspitali University Hospital. Reykjavík, Iccland
No data or information exists on the impact of nursing in Iceland on
patient outcomes, as nursing sensitive patient outcomes have nol
been identified within nursing in Iceland. The purpose of this study
was to describe patient outcomes perceived by nurses in clinical
practice to be relevant to (a) the general patient population and (b)
the patient population within each nursing specialty at LSH. This
paper will focus on results from neuro-rehabilitation nursing.
A survey research design was used. The Nursing Outcomes
Classification (NOC 2nd Ed.) who contains 260 nursing sensitive
patient outcomes, organized into 29 classes, was used in this study.
The NOC survey was translated to Icelandic and mailed to experi-
enced clinical nurses at the hospital (LSH) in November 2001.
Clinical nurses (N=560) from all nursing specialities received the
survey. Responses came from a majority of units within each of the
thirteen nursing specialties. The hospital is an acute-care hospital
with 1260 beds, there were 35,700 inpatient visits, 197,799 out-
patients visits and 2980 child births in the year 2000. It is estimated
that nursing care representing more than 8000 inpatients and 750
child-births created the basis for the nurses' perception of relevant
patient outcomes in this study.
Ninety percent of nursing units (n=54) in the sample were pre-
sented in this study. Respondents had more than one years experi-
ence within nursing, with 36% of respondents had over twenty
years of experience in nursing. Experience within specialty was ever
one year. Significant variance (p< 0.05) by nursing specialty was
found for the perceived relevancy of twenty-five NOC classes.
NOC outcomes perceived relevant to over 50% of patients within
neuro-rehabilitation nursing and those rated relevant to less than
10% of patients will be described.
NOC was an effective tool to describe the perceived relevant
patient outcomes for nursing in general and within specialty. Implica-
tions for clinical practice and further development will be addressed.
62 - Nurses role in the treatment of patients with hyperhidrosis
Wilhelmsson l-L, Eriksson S
Department of Neurology, Uppsala University Hospital
Since treatment of palmar and axillary hyperhidrosis with botuli-
num toxin was introduced in Uppsala 1996 the method has become
increasingly popular and has replaced sympathectomy as the
method of choice for severe cases. A hidrosis outpatient clinic has
been established in collaboration between the dpts. of neurology
and dermatology. Specialised nurses of department of neurology,
familiar with the use of botulinum toxins, organises the clinic and
are the primary contact persons for all patients. The clinic receives
patients with generalised, regional and palmar, plantar, axillary,
facial, inguinal and other focal hyperhidrosis. At the first visit all
patients see a neurologist or a dermatologist to set the right diag-
nosis, exclude other diagnosis and ordination of therapy. Nurses
perform injections of botulinum toxin. When needed, the physician
does regional nerve blocks. Clinical control and repeated injections
at remission as well as iodine starch tests to outline the area of
injections are performed by the nurses. Five years experience of the
clinical problems of the patients, quality of life, technique of injec-
tions with botulinum toxin, improvement and side effects will be
discussed.
63 - Frequency of pressure ulcer on persons with spinal cord
injury in lceland
Kjartansdóttir M
Department of Rehabilitation, Landspítali Grensás, University Hospital, Iceland
Objective: The purpose of this retrospective research was to see the
frequency of pressure ulcer in persons with spinal cord injury 1)
after discharge from rehabilitation ward and 2) frequency of
pressure ulcers when skin was inspected.
Material and methods: The sample was 47, of them 36 were men
and 11 women, and the mean age was 49 years. At the time of the
injury the participants were 15-77 years old and the mean age was
34.7 years. Time from injury was 2-32 years and the mean time was
14.8 years. The participants were graded by ASIA impairment
scale, 47,9% had A or B classification. Number and characteristics
of prior ulcers was self-reported, but recorded by the author. The
participant’s skin was inspected at the same time.
Results: Pressure ulcer frequency was 51,1% (n=24). When skin
was inspected 40,4% had ulcer (n=19). Wheelchair bounded parti-
cipants were 32 (68,1%), of them 22 had ulcer prior to inspection
and 17 had ulcer when skin was inspected.
Conclusion: Pressure ulcers have many causes and in order to lower
their frequency nurses must take actions. They have to record
inspection of the skin and treatment in systematic order. That is the
only way they can have quality control of their treatment of the
skin. Inspection of the skin gives the nurse opportunity to discuss
prevention techniques. Knowledge of prevention techniques will
give the spinal cord injury person more control over their ulcer
development and increase their responsibility for their skin care.
36 Læknablaðið/Fylgirit 43 2002/88