The migration of healthcare professionals,including nurses,is a global phenomenon.It is driven by various factors,including the pursuit of better opportunities,living conditions,and professional development,as well as...The migration of healthcare professionals,including nurses,is a global phenomenon.It is driven by various factors,including the pursuit of better opportunities,living conditions,and professional development,as well as political instability or conflict in their home countries.The World Health Organization(WHO)has noted that high-income countries often rely on foreign-trained nurses to fill gaps in their healthcare systems[1].For instance,as of 2021,over 40%(52 million)of all nurses in the United States(US)were expatriates[2].In the United Kingdom(UK),the percentage of expatriate nurses was even higher,reaching approximately 18%in 2021[3].Owing to globalization and migration,healthcare providers must possess cultural competence to deliver improved care[4,5].Culturally responsive teaching(CRT)is rooted in the idea that culture plays a vital role in shaping people’s behaviors,beliefs,values,and communication styles[6].Furthermore,these cultural factors influence patients’perspectives on health,illness,healing,and their preferences for care and communication[7].By recognizing and embracing these cultural differences,nurses can provide more effective and compassionate care to their diverse patient population[8].展开更多
Introduction:Toxic epidermal necrolysis(TEN)is a medical emergency that most commonly occurs as an adverse effect of certain drugs.Here,we describe a case of a 41-year-old man with no comorbid illness who developed TE...Introduction:Toxic epidermal necrolysis(TEN)is a medical emergency that most commonly occurs as an adverse effect of certain drugs.Here,we describe a case of a 41-year-old man with no comorbid illness who developed TEN.Case presentation:The patient had been prescribed ibuprofen for myalgia and developed skin lesions after the single dose.The lesions were erythematous papules and macules distributed all over the body after ibuprofen intake.TEN was diagnosed based on the patient’s clinical presentation and laboratory findings.He was treated with intravenous dexamethasone,intravenous immunoglobulin,and cyclosporine.Daily dressing changes and skin care was done with saline,chlorhexidine,and liquid paraffin.The patient was intubated and tracheostomized,and he gradually improved and survived.Later,he developed septicemia in the intensive care unit and was treated successfully.Discussion:The management of TEN includes cessation of the causative cause,multidisciplinary intensive care unit(ICU)care,prevention and early detection of sepsis,fluid and electrolyte balance,adequate analgesia and temperature control,proper organ support,aggressive nutritional management,and good psychological support.The pharmacological therapy for TEN includes corticosteroids,intravenous immunoglobulin,and cyclosporine.The key elements of management are aseptic care and proper dressing of the skin.Conclusion:TEN is associated with high mortality if not managed in a systemic and protocolized way.展开更多
文摘The migration of healthcare professionals,including nurses,is a global phenomenon.It is driven by various factors,including the pursuit of better opportunities,living conditions,and professional development,as well as political instability or conflict in their home countries.The World Health Organization(WHO)has noted that high-income countries often rely on foreign-trained nurses to fill gaps in their healthcare systems[1].For instance,as of 2021,over 40%(52 million)of all nurses in the United States(US)were expatriates[2].In the United Kingdom(UK),the percentage of expatriate nurses was even higher,reaching approximately 18%in 2021[3].Owing to globalization and migration,healthcare providers must possess cultural competence to deliver improved care[4,5].Culturally responsive teaching(CRT)is rooted in the idea that culture plays a vital role in shaping people’s behaviors,beliefs,values,and communication styles[6].Furthermore,these cultural factors influence patients’perspectives on health,illness,healing,and their preferences for care and communication[7].By recognizing and embracing these cultural differences,nurses can provide more effective and compassionate care to their diverse patient population[8].
文摘Introduction:Toxic epidermal necrolysis(TEN)is a medical emergency that most commonly occurs as an adverse effect of certain drugs.Here,we describe a case of a 41-year-old man with no comorbid illness who developed TEN.Case presentation:The patient had been prescribed ibuprofen for myalgia and developed skin lesions after the single dose.The lesions were erythematous papules and macules distributed all over the body after ibuprofen intake.TEN was diagnosed based on the patient’s clinical presentation and laboratory findings.He was treated with intravenous dexamethasone,intravenous immunoglobulin,and cyclosporine.Daily dressing changes and skin care was done with saline,chlorhexidine,and liquid paraffin.The patient was intubated and tracheostomized,and he gradually improved and survived.Later,he developed septicemia in the intensive care unit and was treated successfully.Discussion:The management of TEN includes cessation of the causative cause,multidisciplinary intensive care unit(ICU)care,prevention and early detection of sepsis,fluid and electrolyte balance,adequate analgesia and temperature control,proper organ support,aggressive nutritional management,and good psychological support.The pharmacological therapy for TEN includes corticosteroids,intravenous immunoglobulin,and cyclosporine.The key elements of management are aseptic care and proper dressing of the skin.Conclusion:TEN is associated with high mortality if not managed in a systemic and protocolized way.
