British journal of nursing (Mark Allen Publishing)
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There is a vast amount of research available relating to postoperative nausea and vomiting (PONV). This research has been analyzed and summarized in a series of two articles which draw out the main factors influencing the incidence and affecting the treatment of the condition. This, the first article, will describe the physiological processes that result in PONV. ⋯ These factors include personal, preoperative, intraoperative and postoperative variables which affect differing neurotransmitter centres in the chemoreceptor trigger zone (CTZ) which is situated in the brainstem. These variables will then be related to the appropriate neurotransmitter centre allowing a greater understanding of the most likely physiological pathways involved in specific cases of PONV. The second article will explore the management and treatment of PONV.
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The Scope of Professional Practice (UKCC, 1994a) now offers nurses, midwives and health visitors new opportunities to develop their clinical role. Role expansion is at the centre of debate in the health service. In the spirit of Scope, trusts and regional health authorities have been experimenting with new roles that combine medical and nursing practice in order to promote a holistic approach to health care. ⋯ New roles must be evaluated before they are allowed to develop and there is an urgent need for national evaluation of the initiatives underpinning Scope. This article examines the changing role of practitioners in specialist practice. The ethical, professional and legal issues surrounding these changes will also be considered.