In the United States, having limited access to health care has been an ongoing concern that could cause detrimental effects for minority populations, specifically the Hispanic population. Numerous barriers to accessing h...In the United States, having limited access to health care has been an ongoing concern that could cause detrimental effects for minority populations, specifically the Hispanic population. Numerous barriers to accessing health care were identified for both pediatric and adult Hispanic patients who were born with craniofacial conditions. Barriers that were determined to impact Hispanic patients with craniofacial conditions from receiving medical and health services included language and communication, patient-health care provider relationships, socioeconomic status and finances, insurance status, timely access to appointments, citizenship and immigration status, and lack of family and social support. Interventions for these barriers were also proposed to increase support for Hispanic patients. Lamentably, there is scant research that investigates how these barriers affect this special population, despite the limitations that they have in their ability to access health care. In addition, these barriers to treatment have dire consequences for individuals with craniofacial conditions. The findings and proposed interventions discussed in this review article provide measures to minimize these barriers and define ways to benefit Hispanic patients with craniofacial conditions.
In this article, the author focuses on 4 common hair loss disorders that occur in both men and women. The author discusses research related to androgenetic alopecia, telogen effluvium, alopecia areata, and scarring alope...In this article, the author focuses on 4 common hair loss disorders that occur in both men and women. The author discusses research related to androgenetic alopecia, telogen effluvium, alopecia areata, and scarring alopecia and provides details on how to approach and manage these diseases according to patient gender. There are a range of tools and tests that can assist with the diagnostic process and help ensure that relevant and high standards of patient care are maintained. In some cases, no medical intervention is always a treatment option. However, appropriate medical treatments, although still relatively limited in some cases, are safe and have proven efficacy. Hair loss has immense emotional and psychological impact in both genders, and it is always important to consider this when planning hair loss management pathways.
In the past 20 years, the American population has seen an increased demand for nonsurgical minimally invasive facial rejuvenation solutions for the aging process. This widespread and increased demand for cosmetic injecti...In the past 20 years, the American population has seen an increased demand for nonsurgical minimally invasive facial rejuvenation solutions for the aging process. This widespread and increased demand for cosmetic injections brings a greater propensity for complications and adverse events. Choosing suitable patients for dermal filler is essential, as is concrete knowledge of the factors related to adverse events; however, there was no standardized tool to facilitate this process. The Joint Commission's Universal Safety checklist tools have been integrated into hospital surgical operating rooms and ambulatory outpatient settings across America and internationally and have successfully reduced errors in patient safety and outcomes. This article establishes the importance of integrating the Assessment Cosmetic Injection Safety Tool (ACIST), a standardized preinjection safety tool, into the cosmetic practice to decrease the incidence of adverse events associated with dermal filler and to achieve optimal patient satisfaction and outcomes. The ACIST was designed from the scientific literature, piloted at an urban cosmetic practice in the southern United States, finalized on the basis of feedback from participating staff members at the pilot study center, and disseminated to cosmetic nurse injectors.
The number of people undergoing cosmetic procedures (CP) has been growing around the world in recent years. The aim of this study was to determine factors involved in the desire of nurses to undergo CP. A total of 360 nu...The number of people undergoing cosmetic procedures (CP) has been growing around the world in recent years. The aim of this study was to determine factors involved in the desire of nurses to undergo CP. A total of 360 nurses were recruited in this cross-sectional study. Stratified random sampling was used to select the samples. The data were collected using the Social Appearance Anxiety Scale and a questionnaire addressing social factors affecting the desire to undergo CP. More than half of the nurses (56.7%) were willing. Gender, social factors, and social appearance anxiety (SAA) were associated with undergoing CP. The results of logistic regression indicated that women were four times more willing to undergo CP than men, and for each unit increase in SAA score, the odds of desiring to undergo CP increased by 1.04. The Hosmer-Lemeshow test confirmed the goodness-of-fit of the regression model. Moreover, 3 independent variables of gender, SAA, and social factors were powerful predictors of the desire to undergo CP that could explain 39.9%-53.6% of changes in the desire to undergo CP. Further studies are needed to investigate the amount of CP and motivations to undergo CP in nurses.
Advanced practice in nursing is well established and has been active since the 1800s. In most cases, the role was developed because of a specific need or gap in patient care. Advanced practice nurses (APNs) have been exp...Advanced practice in nursing is well established and has been active since the 1800s. In most cases, the role was developed because of a specific need or gap in patient care. Advanced practice nurses (APNs) have been experts in medical aesthetic injections for more than 30 years. The APNs' independence became increasingly common as a mechanism of continuity of care for the non-surgical-medical aesthetic patients. The APN role has evolved, and nurse practitioners (NPs) are now collaborating with nurses safely and effectively in nurse-led clinics in medical aesthetics. There are specific education and college regulations that are required to ensure patient safety in this collaborative care model. The role of the NP in a nurse-led medical aesthetic clinic is an accepted and recognized independent practice role that creates an innovative and well-regulated approach to patient care.
New virulence factors, such as the Panton-Valentine leukocidin (PVL), are appearing during Staphylococcus aureus infections occurring in the pediatric population. Such factors increase the aggressiveness and risk of diss...New virulence factors, such as the Panton-Valentine leukocidin (PVL), are appearing during Staphylococcus aureus infections occurring in the pediatric population. Such factors increase the aggressiveness and risk of dissemination of the bacteria, causing infections to be life-threatening. An early diagnosis is thus especially important. We present a case of osteomyelitis, venous thrombosis, and septic emboli occurring in a pediatric patient that should trigger suspicion of a PVL-positive strain. A multidisciplinary approach is necessary to enable rapid diagnosis and early treatment, which is essential for successful management of these infections. Management is based on broad-spectrum antibiotics, in combination with aggressive surgical treatment and antithrombotic therapy. In patients infected with S. aureus whose condition worsens quickly, PVL gene sequencing should be considered.
The development of a nonhealing ulcer on a chronic wound or scar should raise suspicions of the plastic surgeon or nurse regarding the potential for malignant degeneration to a Marjolin ulcer. Occasionally, a Marjolin ul...The development of a nonhealing ulcer on a chronic wound or scar should raise suspicions of the plastic surgeon or nurse regarding the potential for malignant degeneration to a Marjolin ulcer. Occasionally, a Marjolin ulcer may present as exophytic granulation tissue within a scar. Most Marjolin ulcers are well-differentiated injuries; however, because of their aggressive nature and poor prognosis, to ensure surgical success, diagnosis of Marjolin ulcer should be confirmed and treatment initiated as soon as possible.
Medication shortage is a problem that affects patients, providers, and institutions of all sizes and scope across the United States. The objective of this quality improvement project was to promote the appropriate use of...Medication shortage is a problem that affects patients, providers, and institutions of all sizes and scope across the United States. The objective of this quality improvement project was to promote the appropriate use of multi-dose vials (MDVs) by anesthesia providers at an independent plastic surgery office. Multi-dose vials can be used to decrease waste and potentially cost, thus increasing access to necessary medications for the patients at this practice. A focus group was used to obtain an understanding of barriers to the use of MDVs at this practice. A focused E-learning module on safe use based on established guidelines was then created, and a simplified flow sheet was implemented and placed in medication preparation areas as a cognitive aid. The education and flow sheet focused on identification and preparation of the medication area, proper identification of MDVs versus single-use vials, hand hygiene, proper beyond-use labeling, septum cleaning, use of a new sterile syringe and needle, and administration time frames. Provider feedback included high levels of satisfaction with the E-learning module. Our comparison of the use of ketamine from MDVs during the pre- and postimplementation phases showed a 14% increase in the number of doses used per vial. This finding suggests that were similar practices implemented at a larger site with MDVs of medications other than ketamine, resources could be impacted to manage shortages and increase access to medications.