Journal of advanced nursing
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Evidence indicates that, although nurses are increasingly using clinical guidelines to ensure higher quality of care, there is a wide variance in their adherence to them. The utility of the Theory of Planned Behaviour (TPB) has not been previously investigated in explaining this variance in community nursing. ⋯ Future trials of interventions to increase practice nurses' adherence to clinical guidelines could attempt to address the elements identified in this study as important factors. Further studies are required to examine the utility of the TPB in predicting practice nurses' behaviour.
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Coronary artery bypass graft (CABG) surgery is a lifesaving intervention, but the early recovery period presents a number of challenges for patients, carers and nurses. Early and adequate discharge planning based on in-depth knowledge of the postdischarge experience can help to ensure optimal recovery. ⋯ The findings suggest a need to improve discharge preparation and provide enhanced home support services. Further research should evaluate models of periodic follow-up and mechanisms for mutual support, and compare the experiences of cardiac patients and their carers with those of other surgical cohorts.
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Randomized Controlled Trial Clinical Trial
Preventing hypothermia during continuous veno-venous haemodiafiltration: a randomized controlled trial.
Continuous veno-venous haemodiafiltration is a common form of dialysis used in intensive care units. Unfortunately, patients often experience hypothermia as a side-effect of the therapy because of the necessity for extracorporeal blood flow. Intensive care nurses aim to prevent hypothermia developing. Intravenous fluid warmers are sometimes added to the dialysis circuit in an attempt to maintain patient temperature. However, the efficacy of this method has not been previously studied. ⋯ Intravenous fluid warmers used as described do not prevent hypothermia during continuous veno-venous haemodiafiltration. Female patients and those with a low-normal baseline temperature are most likely to become hypothermic during this form of dialysis. Further research is needed to address effective ways of preventing hypothermia in critically ill patients receiving continuous renal replacement therapies.
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Although minor facial injuries are relatively common, their psychological impact is an area neglected in the literature. For physiologically major injuries (such as facial cancers, burns and fractures), the face has been suggested to be a psychologically significant area of the body and disfigurement has been found to have numerous potential social consequences for patients. ⋯ Minor facial scars can have significant psychological impact for some people. Awareness training for health professionals, social skills training for affected patients and a patient information leaflet are recommended.
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The 'information explosion' presents a significant challenge to the nursing profession. One way to assist access to information is to provide electronic information resources at the point of care. A large-scale survey of nurses working in the public health system in New South Wales, Australia, was undertaken as part of a 2-year evaluation of the Clinical Information Access Program (CIAP). This is a website which provides 24 hour, online access to a range of evidence sources at the point of care. ⋯ Use of online evidence was associated with nursing role, and with managerial and organizational support. Diffusion of innovation theory can help to explain some of the patterns observed. The use and impact of online evidence should be interpreted in the context of nursing practice and culture.