A meaningful health assessment course for baccalaureate nursing students

In response to the challenge of teaching health assessment to large groups of entry-level BSN students with minimal experience in the health professions and a faculty belief that theory and practice are best actualized with small groups, a new health assessment course was implemented. Based on a philosophy of student accountability and self-direction in learning, faculty willingness to try new teaching strategies, and using computer testing, a successful course was developed. Students rotated through specific small group clinical labs while preparing with textbooks, study questions, videotapes, and computer-assisted instruction. Evaluation methods based on case application and the use of computer testing technology were implemented for this course. The result was increased satisfaction for the faculty and the students with enhanced application experiences supportive of the clinical practice.     

Issues related to school attendance of black baccalaureate nursing students

Studies have shown an increased spontaneous TNF alpha production, and the 24--rhythmicity of TNF blood concentration in patients with advanced cancer. The present study investigates whether diurnal rhythmicity of endogenous TNF alpha is associated with the induction of circulating sTNF Rp55 in advanced gastrointestinal neoplasm. The levels of endogenous TNF alpha and sTNF Rp55 in serum were measured at 8 a.m., 2 p.m., 6 p.m., 10 p.m., 2 a.m., and again at 8 a.m. RESULTS: There is circadian rhythm in the secretion of endogenous TNF alpha in patients with advanced gastrointestinal cancer, however no diurnal rhythm of sTNF Rp55 was observed. Since it has been suggested that human tumors susceptible to TNF alpha may escape destruction by secreting or inducing the secretion of sTNF Rp55 to block the effects of TNF alpha, the possibility that the observed fluctuations could also reflect the complexation of a proportion of the receptor molecules with their ligand should be considered.     

Training and use of baccalaureate nurses

One thousand three hundred sixty-five soldiers from the U.S. Army completed a 30-item version of the Childhood Trauma Questionnaire (CTQ) together with four questions on sexual abuse developed for a national survey of U.S. adults. A four-factor solution to the CTQ produced four subscales that were similar to those found in the original study, namely (1) emotional neglect, (2) physical and emotional abuse, (3) sexual abuse, and (4) physical neglect. We found that half of female soldiers reported a childhood history of sexual abuse, compared with one-sixth of male soldiers. Half of both male and female soldiers reported a childhood history of physical abuse. Combined abuse histories were noted in 34% of female and 11% of male soldiers. Abused soldiers reported more psychological symptoms on the Brief Symptom Inventory than nonabused soldiers. The CTQ and screening questions are discussed as possible tools for eliciting histories of abuse from soldiers.     

Ethical conflicts reported by certified registered rehabilitation nurses

Psychological and neuropsychological assessment of children is focused on behavioral disorders of various dimensions (e.g., abilities and limits of perceptual, expressive, cognitive and emotional functions). Additionally neuropsychological diagnosis attempts to explain relationship between behavioral and brain states. The purpose of diagnosis formulated in this way requires careful selection of test procedures and overall integration of different kinds of data. Especially, severally handicapped cases need this kind of diagnostical approach. Limits of valid diagnostic conclusions are determined by many factors that affect coherent interpretation of the test scores (e.g. the lack of a consistently employed neurologic model of brain development to relate to behavioral functions, significant impairment with coexisting sensory and motor deficits, the different effects of brain lesion depending on age of onset, the interference of maturational and experimental variables with manifestation of brain damage).     

Stress in nursing students and graduate nurses in inpatient psychiatry

This article deals with differences in work satisfaction, general state of well being, somatic complaints and work load of psychiatric student nurses and graduated nurses. Data were collected from a sample of 53 psychiatric student nurses and 145 graduated nurses. The graduated nurses reported an unexpectedly high job satisfaction of 70% compared to other working groups in hospitals. The student nurses were more content with their work and reported less somatic complaints. Furthermore the student nurses found in 20 cases certain duties less strenuous. In addition, the student nurses reported a more negative general state of well being.     

Perceptions and practice of universal blood and body fluid precautions by registered nurses at a major Sydney teaching hospital

Detection of Newcastle disease virus (NDV) and avian pathotyping of NDV isolates are extremely important because the appearance of virulent virus has significant economic consequences in terms of vaccination, eradication, and the ability to export poultry products. By using nucleotide and amino acid (aa) homology analysis, we could demonstrate that a NDV broiler isolate is a velogenic virus. This analysis was done after mean death time and intracerebral pathogenicity index tests gave inconsistent results. By establishing a nucleotide sequence dendrogram, we found that the disputed Ber-Tuvia was clearly in the same group as the known Herev-Laet, a velogenic isolate. The difference between Ber-Tuvia 92 and the Herev-Laet velogenic isolate was 6% as opposed to > 16% of the meso- and lentogenic isolates. The Ber-Tuvia isolate contains the Arg/Arg and Lys/Arg aa at positions 112, 113 and 115, 116, respectively, in the fusion protein cleavage aa sequence, which is typical for virulent NDV isolates.     

Declarations by registered nurses from the 1980s: an aid to the understanding of nursing today

This study is part of a more extensive project that aims to rescue significant aspects related to the evolution of nursing care from 1950s until 1990s. This study was developed using the technique of oral declaration by active and retired registered nurses, in the context of a school-hospital from the interior of the S?o Paulo State. The present study particularizes the outcomes regarding to 1980s. As result becomes evident the undertaken effort by nurses in the struggle for profession's recognition and prestige; intense and deep transformations related to nurse's new roles as leadership of the nursing staff and members of the medical team.     

On target: a model to teach baccalaureate nursing students to apply critical thinking

The majority of thyroid tumors are not homogeneous histologically, this creating difficulties in interpretation of different carcinoma variants. The aim of the study was a complex comparative study of morphogenetic changes in carcinoma, adenoma and surrounding thyroid tissue. Surgical material from 48 patients operated because of nodular (multinodular) euthyroid goiter in Moscow Medical Academy in 1990-1997 was used. It was established that all the observations of early thyroid carcinoma diagnosed clinically as a nodular (multinodular) euthyroid goiter were represented by differentiated forms of thyroid carcinoma. Thyroid carcinoma was characterized by higher values of biomolecular markers as compared to adenomas and surrounding tissue. High values of c-myc expression in adenomas and surrounding tissue may indicate possible genetic rearrangements. A peculiar feature of carcinomas was the fact that deletions and replication errors in malignant tumors in this study were found simultaneously in the three genes investigated. As to different histological types of carcinoma, the most frequent deletions of the genes studied were observed in medullary and papillary-follicular carcinoma. High values of heterozygosity loss were found already in adenomas and surrounding tissues, this indicating the presence of the genetic changes already in the benign tumors and surrounding tissue.     

Effectiveness and patient satisfaction with screening flexible sigmoidoscopy performed by registered nurses

CONTEXT: In December 1995, reported Salmonella enterica serotype Newport (SN) infections increased sharply in Oregon and British Columbia but not elsewhere in North America. Similar unexplained increases had been noted in 6 other states in the fall of 1995. OBJECTIVE: To determine the source of the outbreak(s). DESIGN: Case-control studies, environmental investigations, bacterial subtyping, and surveillance information review. SETTINGS: Oregon and British Columbia communities (winter 1995-1996) and Georgia, Oklahoma, Pennsylvania, Vermont, Virginia, and West Virginia (fall 1995). PARTICIPANTS: Oregon and British Columbia residents with culture-confirmed SN infections and onset from December 1, 1995, through February 29, 1996, and healthy community controls. MAIN OUTCOME MEASURES: Odds ratio (OR) of illness associated with exposures; distribution patterns and culture of alfalfa seeds and sprouts; subtyping of SN isolates. RESULTS: We identified 133 cases in Oregon and British Columbia; 124 (93%) occurred in patients older than 18 years; 87 (65%) were female. Case patients were more likely than community control subjects to report having eaten alfalfa sprouts in the 5 days preceding illness (41% [17/41] vs 4% [3/75]; OR, 17.0; 95% confidence interval, 4.3-96.0). Case isolates shared a distinctive pulsed-field gel electrophoresis (PFGE) pattern. The SN was grown from seeds and alfalfa sprouts. The distribution of 1 seed lot to multiple growers corresponded to the distribution of cases. Distribution of a second seed lot from the same European wholesaler corresponded to the location of the fall outbreak, which was characterized by a similar demographic profile. The PFGE pattern of fall outbreak isolates and confiscated sprouts and seeds was indistinguishable from the Oregon and British Columbia outbreak and differed from background isolates. CONCLUSIONS: The SN-contaminated alfalfa seeds were distributed to multiple growers across North America in 1995 and resulted in a protracted international outbreak scattered over many months. Current sprouting methods are inadequate to protect consumers from such events. Alfalfa sprouts may be an elusive but important vehicle for salmonellosis and other enteric infections.     

Ratings of the performances of practicing internists by hospital-based registered nurses

PURPOSE: To examine the feasibility and reliability of ratings completed by hospital-based registered nurses of the humanistic qualities, communication skills, and selected aspects of the clinical skills of practicing internists. METHOD: In 1988-1989, registered nurses who worked in the same 175 hospitals as 232 internists with admitting privileges at these hospitals rated the internists' performances. The nurses were selected from medicine floors, specialty floors, and intensive care units and/or critical care units, using lists provided by head nurses. A total of 1,877 rating questionnaires with 13 performance categories were collected (with a mean of 8.01 nurses per internist). The ratings were analyzed to determine measurement characteristics and the relationships of the nurses' demographic characteristics to the ratings. In addition, for each of ten performance categories for 152 of the internists, the average rating each internist received from nurses was compared with the average rating each internist received from peer physicians. Statistical analysis used Pearson correlations, canonical correlations, factor analyses, Student's t-tests, analysis of variance, and stepwise multiple regression. Finally, the internists themselves, including physicians who were not actually rated by the nurses, were asked to complete a brief questionnaire that included questions about their opinions of the use of nurses' ratings. RESULTS: The nurses' ratings correlated moderately strongly with the peer physicians' ratings and had a common structure. However, the nurses' ratings were lower for several humanistic qualities, including respect, integrity, and responsibility, and their ratings were higher for medical knowledge and verbal communications. Across the 13 performance categories, approximately 10-15 ratings from nurses were needed to obtain a reliable assessment of an internist's humanistic qualities and communication skills. Many internists felt that nurses' ratings should be used equally with, or at least as a lesser contribution to, ratings by peer physicians of humanistic qualities and communication skills. CONCLUSION: Nurses' ratings appear to provide a feasible and reliable method of evaluating the internists' communication skills and humanistic qualities, when used in conjunction with ratings by peer physicians.     

Teaching pharmacology to advanced practice nursing students: issues and strategies

A pharmacology course should prepare the advanced practice nursing student to understand the cellular mechanisms of drug action and physiologic outcomes (pharmacodynamics); mechanisms of absorption, distribution, metabolism, and excretion of drugs (pharmacokinetics); and the clinical use of drugs in the diagnosis, prevention, and treatment of disease (pharmacotherapeutics). The goal of a pharmacology course for advance nursing practice is to provide practitioners with knowledge that provides a rational basis for pharmacologic management of patients with complex health problems. A pharmacology course should teach the student the principles of pharmacology along with the process of pharmacologic reasoning.     

Staff attitudes to oral health care. A comparative study of registered nurses, nursing assistants and home care aides

The diagnosis of early ectopic pregnancy remains challenging for the gynecologist. Although early detection of a suspected pregnancy has been facilitated by quantitative beta human chorionic gonadotropin studies and ultrasonography, a patient subgroup remains with an ambiguous presentation. In this group of patients, the clinician must rely on microscopic examination of products of conception in a uterine curettage specimen to rule out the presence of an extrauterine pregnancy. The presence of an implantation site, chorionic villi, or trophoblastic tissue in uterine curettage samples is conventionally held as definitive evidence of an intrauterine pregnancy. We present a series of four cases that challenge this convention. In these cases, chorionic villi or an implantation site were identified in uterine samples of pregnant women who each ultimately proved to have an ectopic pregnancy. If clinical suspicion is high, the finding of either chorionic villi or an implantation site should not preclude further workup of a possible ectopic pregnancy. In cases where only a few villi or a single chorionic villus are identified, other signs of intrauterine implantation such as intermediate trophoblastic cells, hyalinized vessels, and a fibrinoid matrix should be sought to establish firmly the diagnosis of an intrauterine pregnancy.     

What do registered nurses and midwives feel and know about research?

This research is in the form of a quantitative study aimed at discovering 'What registered nurses and midwives feel and know about research'. Data were gathered on a fixed response questionnaire, with open spaces for comments to support the results with written factual qualitative evidence. The questionnaire was directed towards obtaining results associated with 'Attitudes' towards research; 'Understandings' about research, and 'Obstacles' to implementing research. A sampling technique was used in which a total population of 765 registered nurses and midwives working in this district general hospital were involved in the study. The results demonstrate (inferential statistics chi-square and correlation tests) that registered nurses and midwives are largely in agreement with research based practices, although understanding about research is minimal and dependent on grade, length qualified, shifts and numbers of hours worked.