Journal of advanced nursing
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Caring is a difficult, elusive concept not only to define but also to measure. Eleven different quantitative instruments designed to measure caring are reviewed. Out of these 11 caring instruments, seven are Likert scales, two are visual analogue scales, one is a checklist, and one is a Q-sort. ⋯ Comparison of these instruments revealed that different aspects of caring are measured by these tools such as caring behaviours, satisfaction with caring behaviours, ability to care, and response to caring behaviours. Some caring instruments are designed to be completed by patients only, by nurses only, or by either patients or nurses. Multiple factors need to be taken into consideration by nurse researchers in deciding which instrument to use to measure caring.
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This prospective correlational study examined nurses' perceptions of collaborative nurse-physician transfer decision making as a predictor of patient outcomes in a medical intensive care unit, adjusting for risk. The convenience sample consisted of 175 patient transfer decisions. Charts and computerized databases were used to collect patient information, and a questionnaire developed by the investigator was used to obtain demographic data from the 42 medical intensive care nurses. ⋯ Hierarchical logistic regression analyses first showed that the nurses' perceptions of collaboration were not a significant predictor of patient outcomes. Furthermore, the analysis also showed that decision task complexity and the nurses' years of critical care experience did not significantly moderate the contribution of nurses' perceptions of collaboration to patient outcome prediction. Finally, a Pearson product moment correlation coefficient of 0.28 revealed a statistically significant (P = 0.000), positive relationship between the nurses' perceptions of collaboration and their satisfaction with the decision making process about decisions to transfer.
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Despite the advent of new technology and pharmacological agents, post-operative nausea and vomiting (PONV) continues to have an incidence of 20-30% today. Development of PONV can lead to serious complications such as aspiration, dehydration, electrolyte disturbances and disruption of the surgical site. ⋯ The mechanisms of PONV are examined with associated risk factors. A review of the literature of PONV management is included covering pharmacological, dietary and behavioural interventions; culminating in the development of assessment and management guidelines and identification of areas for further study.
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Review
Normal saline instillation with endotracheal suctioning: primum non nocere (first do no harm).
Normal saline instillation, in conjunction with endotracheal suctioning, is purported to be beneficial in removing thick and tenacious secretions for patients receiving mechanical ventilation. Guidelines for this routine procedure are inconsistent and its efficacy is unsupported by research-based evidence. This discussion paper highlights that the procedure produces no physiological benefits for the patient and, indeed, may have detrimental effects on the patient's psychological wellbeing. It is proposed that after 25 years of inconsistent practice in trying to remove thick and tenacious secretions, it is time to focus on techniques to prevent thick and tenacious secretions.