The Journal of cardiovascular nursing
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End-of-life care involves not only the care of patients but also the care of those providing care for patients. The routine demands of providing care for patients in end-of-life situations often prevent nurses from working through the grief associated with the death of a patient, resulting in frustration, depression, stress, and eventually, burnout. It is important to recognize that grief and mourning are necessary steps in adjusting to the loss associated with the death of a patient or a loved one. ⋯ As nurses providing quality end-of-life care, we can provide an opportunity for a patient's family to begin the process of grieving through appropriate interventions while the patient is still in the hospital or care facility. Recognizing and respecting the appropriateness of individual differences in grief responses creates a means of support for both patients and professionals in healthcare settings. By understanding grief as a predictable, yet individual, response to the loss of a patient or a loved one, we, as nurses, can take care of ourselves while providing quality end-of-life care for our patients.
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The purpose of this study was to describe registered nurses' (RNs') perceptions of factors influencing care for patients in the palliative phase of end-stage heart failure (ESHF). Seventeen senior RNs across 3 acute care and 5 community centres in metropolitan Adelaide, Australia, participated in the study. In this descriptive, exploratory research project, we analyzed audiotaped indepth, semistructured interviews, using a computer-assisted (NVIVO) thematic procedure. ⋯ Care of patients with ESHF should promote the amalgamation of technological and pharmaceutical advances in the treatment of heart failure with more timely end-of-life care. All involved parties must work toward advancing a common middle ground for appropriate end-of-life care for patients with ESHF. Recommendations for practice include the need for greater education for patients and their families and greater collaboration between the members of the multidisciplinary healthcare team to assist patients with ESHF and their families prepare more timely for the final trajectory of the illness.
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High blood pressure has become increasingly prevalent and is an important risk factor for cardiovascular disease. The Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) has redefined normal blood pressure as less than 120/80 mm Hg and created a new blood pressure category called "prehypertension" for those with a systolic BP of 120 to 139 mm Hg or a diastolic BP of 80 to 89 mm Hg. This new blood pressure category was created to identify adults considered to be at risk for developing hypertension and to alert both patients and healthcare providers of the importance of adopting lifestyle changes. Recognition of prehypertension provides important opportunities to prevent hypertension and cardiovascular disease.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Public defibrillation: increased survival from a structured response system.
The Public Access Defibrillation (PAD) trial was a prospective, randomized, controlled study designed to compare the number of persons surviving to hospital discharge after experiencing an out-of-hospital cardiac arrest (OOH-CA) among "community units" randomized to receive cardiopulmonary resuscitation (CPR) only or CPR plus an automated external defibrillator (AED). In 24 centers across the United States and Canada, 993 community units, composed of 1260 individual facilities, trained more than 19,000 layperson responders in CPR-only or CPR+AED. ⋯ Use of an AED within this structured response system can increase the number of survivors to hospital discharge after OOH-CA. Trained nonmedical responders can use AEDs safely and effectively.