Use of a Delphi technique to prioritize clinical nursing research needs

School of nursing faculty and nursing service personnel at an academic medical center in the South, collaboratively using a Delphi method, were able to prioritize the top three unit based clinical nursing research needs. The benefits were evident as research conducted at the staff level linked the research efforts with the quality improvement efforts on the Labor, Delivery and OB Receiving Units. The Delphi method, a consensus building technique, offered a clear, concise, accurate and non-threatening approach for staff nurses to participate in research.     

Spiritual nursing interventions

Oncology, parish, and hospice nurses in the Midwest were surveyed to explore what nursing interventions they implement to enhance the spirituality of clients and how they learned about these interventions. Some 95 spiritual nursing interventions were identified and ranked according to frequency of implementation. The most frequently identified nursing interventions were referral, prayer, active listening, facilitation and validation of clients' feelings and thoughts, conveying acceptance, and instilling hope. The most frequently ranked implemented interventions were communication and religious nursing interventions. Only 15% of the participants indicated that they learned the most about spirituality and spiritual nursing interventions from basic and advanced nursing education combined. Findings support the need for increased emphasis of theoretical and clinical spiritual knowledge in nursing education and the development of a typology of spiritual nursing interventions to direct nurses in enhancing the spirituality of clients and implementing holistic nursing care.     

Quantifying psychosocial nursing interventions provided to geropsychiatric inpatients

Homocysteine is a metabolite of methionine that may be remethylated by enzymes requiring folate and cobalamin (vitamin B12) to again form methionine or catabolized by the pyridoxine (vitamin B6) dependent enzyme, cystathionine beta synthase (CBS) to form cysteine (fig. 1) [1]. Homocysteine exists as a combination of various free and protein bound forms, but the total amount is what is usually measured and may be reported as homocyst(e)ine [2]. The biological plausibility that elevated homocysteine might lead to vascular disease noted in 1969 by McCully [3]. He reported that a child with abnormal cobalamin metabolism and hyperhomocysteinemia had arterial lesions similar to those seen in children with severe hyperhomocysteinemia from CBS deficiency. These findings led to the idea that moderate elevations in homocysteine, even those still within the so-called normal range, might also lead to vascular pathology through a variety of mechanisms including atherosclerosis and thrombosis [4].     

Fathers' childbirth experience and nursing interventions

The purpose of the study was to describe the childbirth experience of fathers and nursing interventions used during labour and delivery. The data were collected by questionnaires from fathers attending delivery room during one month (n = 137). Five fathers refused to participate. The return rate was 81% out of 132 fathers. Data analysis included cross tabulations, factor analysis as well as content analysis for open ended questions. Nursing interventions which fathers found supportive were infant care, getting information and attention from the staff. Most of the respondents felt they got encouragement to take care of the infant. They also got information of the delivery and newborn's welfare. However, about half felt they got little encouragement to show their own feelings. Fathers found that being present at the delivery was an important part of their fatherhood. The best moments were attached to enjoyment of taking care of the newborn. Fathers felt themselves unable to help their partner enough. They felt very difficult to see their partner in pain. Most of the father were quite satisfied with nursing interventions used during labour. They wanted more attention to be paid to pain management. Fathers would like to get more advice during labour.     

Perioperative nursing interventions for intravascular stent placements

Keeping abreast of changing surgical technologies is among the more challenging aspects of perioperative nursing. Because peripheral vascular disease is a leading cause of lower extremity disabilities that require surgical interventions, new procedures and techniques are being developed continually. These procedures involve the insertion of intraluminal structural supports into patients who have had mixed or unsuccessful results from angioplasty. Perioperative nurses are an integral part of vascular surgery teams performing the insertion of intravascular stents. To function effectively, perioperative nurses must understand the concepts of intravascular stent procedures, nursing diagnoses, and nursing interventions that promote optimal patient outcomes.     

髋关节翻修术的护理进展

人工髋关节翻修术与首次髋关节置换术相比,手术更为复杂、困难.通过对10例人工髋关节翻修术患者的护理,指出术前有针对性的心理疏导,术后预防并发症和出院指导,提高了患者的康复能力及生活质量.     

高血压脑出血术后的护理体会

脑外科ICU集中收治重症颅脑外伤、高血压性脑出血钻孔引流术后、蛛网膜下腔出血、脑干出血的患者,尤以高血压性脑出血居多.其病情危重,病情变化快,预后差,生活质量低下.因此精心的护理能及时发现病情变化,减少并发症,提高生活质量,促进康复.     

老年患者人工髋关节置换术的护理体会

目的:探讨老年人工髋关节置换术的护理方法.方法:对32例髋关节置换术患者加强生命体征监测和患肢护理,预防并发症,并指导合理的功能锻炼.结果:术后发生电解质紊乱1例,脱位1例,经积极治疗均痊愈出院.结论:对老年患者的正确护理和康复训练,可促进病情康复,提高生活质量.     

Simultaneous kidney pancreas transplantation: patient issues and nursing interventions

Nursing care across the service delivery continuum is essential for patients undergoing simultaneous kidney pancreas transplantation. The self-management of complicated treatment choices and care regimens requires education and support, which are the domain of transplant nursing coordinators. Even successful transplantation is associated with complications in the first 6 months. Continuous posttransplant nursing interventions to monitor patients, teach and reinforce self-care, and support adjustment is crucial to patient well-being. This article describes nursing strategies used at one transplant center to address these patient needs.     

Multicultural issues and ethical concerns in the delivery of nursing care interventions

Targeted mutagenesis was used to investigate the roles of the CsmA and CsmC proteins of the chlorosomes of the green bacteria Chlorobium tepidum and Chlorobium vibrioforme 8327. Under the photoautotrophic growth conditions employed, CsmA is required for the viability of the cells but CsmC is dispensable. The absence of CsmC caused a small red shift in the near-infrared absorption maximum of bacteriochlorophyll d in whole cells and chlorosomes, but chlorosomes were assembled in and could be isolated from the csmC mutant. The doubling time of the csmC mutant was approximately twice that of the wild-type strain. Fluorescence emission measurements suggested that energy transfer from the bulk bacteriochlorophyll d to another pigment, perhaps bacteriochlorophyll a, emitting at 800-804 nm, was less efficient in the csmC mutant cells than in wild-type cells. These studies establish that transformation and homologous recombination can be employed in targeted mutagenesis of Chlorobium sp. and further demonstrate that chlorosome proteins play important roles in the structure and function of these light-harvesting organelles.     

Self perception: the key stone of nursing interventions with hyperactive children

Denise Dumas, a nurse at the H?tel-Dieu du Sacré-Coeur de Jésus hospital, in Quebec City, and Louise Pelletier, an associate professor at the Ecole des sciences infirmières of Université Laval, are interested in promoting understanding of problems linked to hyperactivity in school-age children. They suggest appropriate nursing interventions for child psychiatry units in hospitals and outpatient clinics. The authors give a definition of attention-deficit hyperactivity disorder, specifying its prevalence, etiology and treatment, and describe the behaviour of the hyperactive child. They go on to look at the concept of self-perception and deal with its development and its importance in children's lives. Most importantly, the authors suggest nursing interventions suited to the needs of hyperactive children.     

Play therapy instruction: A model based on objectives developed by the Delphi technique.

The purpose of this study was to determine the core skills/methods and practicum experiences play therapy experts and professors believe to be essential in the education of the beginning play therapist in the specific areas of theory, history, terms, organizations, authors who have contributed to the field, methods, skills, training in special populations, practicum experience, and advanced skills. Using the Delphi technique, two questionnaires were used to obtain opinions from play therapy experts and play therapy instructors. The first scale was sent to twelve play therapy experts to obtain their opinions on the core curriculum and experiences necessary for training a play therapist in an introductory play therapy class, practicum experience, and advanced play therapy training. Frequencies and means were obtained and used to delete and add items for the revised scale. The revised scale was sent to 180 play therapy professors. Fifty play therapy professors returned the instrument. The professor's ratings were used to develop curriculum content for training play therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparative study of methods to validate formaldehyde decontamination of biological safety cabinets

Methods of validation of formaldehyde decontamination of biological safety cabinets were compared. Decontamination of metal strips inoculated with Mycobacterium bovis, poliovirus, or Bacillus spp. spores was compared with the results obtained with three biological indicators. Conditions for successful decontamination, particularly relative humidity, were defined. The Attest 1291 biological indicator was the only biological indicator which was an aid in the detection of gross decontamination failure.     

Behavioral analysis and nursing interventions for reducing disruptive behaviors of patients with dementia

In this study, two cases were used to examine the potential of behavioral analysis as an intervention to decrease disruptive behaviors of institutionalized individuals with dementia. Behavioral modeling was used to teach the principles of behavioral analysis. The nurses observed a behavior change plan implemented by the investigator, revised the plan based on behavioral analysis techniques, and subsequently implemented the revised behavioral strategies. The patients' disruptive behaviors decreased markedly when the behavioral intervention was implemented. Patients resumed disruptive behaviors when care was provided without the behavioral plan. The findings suggest the need to address interventions in nursing research, education, and practice that use behavioral analysis to reduce disruptive behaviors in individuals with dementia.     

A cost and value analysis of two interventions with incontinent nursing home residents

OBJECTIVE: More than half of nursing home residents suffer from urinary incontinence. These residents typically have long stays and, because of comorbid cognitive and physical impairments, have little hope of living again in a noninstitutional environment The value of interventions to change functional status of this chronically institutionalized population is often questioned. This paper explores this value issue in the context of two incontinence management interventions that have been shown to improve functional status: (1) Functional Incidental Training (FIT), and (2) Prompted Voiding (PV). The relative value of the different interventions for the nursing home population was estimated using paired preferences. DESIGN: The cost of two interventions (FIT and PV) that target incontinent nursing home residents was related to the value of these interventions as perceived by consumers of nursing home services. Both interventions decrease incontinence frequency, and one intervention also improves mobility endurance. PARTICIPANTS: Ninety incontinent nursing home residents received the intervention; 37 older nondemented board and care residents and 31 family members of the nursing home residents provided estimates of the intervention's value. MEASUREMENT: The staff-time allocations involved in implementing both interventions were documented in more than 85 resident care episodes. These time data were converted to labor cost based on the cost of nursing aides who would actually implement the intervention. The value of each intervention was assessed by asking consumers to make choices between the intervention and its associated outcomes (such as increased dryness) and other nursing home services of known cost (e.g., moving to a private room). RESULTS: Both interventions had labor costs that were greater than "usual care" costs. The additional cost was estimated to be $4.31 per resident per day for PV and $6.42 per resident per day for FIT if these programs were implemented from 7 AM to 7 AM. Consumer preference data indicated that consumers preferred the FIT and PV outcomes to more expensive alternative services, calculated to cost $10.00 per day, often marketed to consumers, CONCLUSION: Consumers may prefer the FIT and PV interventions relative to the typical services often marketed to the nursing home consumer. The analysis completed in this paper suggests that both interventions have value for frail residents likely to live out their lives in a nursing home.     

Delphi下利用DDE实现同RsLinX通信

根据炼铁新厂煤气放散塔自控系统的运行情况，从RockWell工控软件RsLinx入手，分析了RsLinx软件的通讯方式，提出了采用动态数据交换技术的通讯方案。并用Delphi编制程序，实现了数据远传和显示，声音报警等功能，保证了煤气系统安全运行。同时也为数据存储，不同工控系统数据交换提供了一种方法。     

The future of psychotherapy: A Delphi poll.

Predicted psychotherapy trends in the next decade by using the Delphi poll. 36 therapists and researchers completed a 100-item questionnaire assessing possible changes in therapeutic interventions, psychotherapists, therapy modalities, theoretical orientations, research findings, and professional issues. Results indicate that therapy will become more cognitive behavioral, present centered, problem specific, and briefer; cathartic, aversive, and dynamic approaches are expected to decrease. Family and marital therapy are predicted to markedly increase; long-term individual modalities are expected to markedly decrease. Optimistic forecasts include an increase in women and minority therapists, accelerated services to underserved populations, coverage under national health insurance, and standard implementation of peer review. One emerging pattern suggests that psychotherapists' efforts at change will become more similar to self-change processes that are used by people in their natural environment. The impermanent nature of psychotherapy and the deleterious consequences of this impermanent condition are discussed. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)