A controlled trial to compare the ability of foam swabs and toothbrushes to remove dental plaque

AIMS OF THE STUDY: To measure how effective foam swabs are at removing dental plaque when compared with using a toothbrush and to quantify any difference in ability. BACKGROUND: Few nursing studies have aimed to determine the effectiveness of different mouth care tools to remove plaque which is associated with the tooth/gingival margin and, therefore, with gingivitis and chronic inflammatory periodontal disease. Findings from a previous case study of two people that compared the ability of foam swabs and toothbrushes to remove plaque at the gum/tooth margin (gingival crevice) and plaque from between teeth (approximal plaque) suggested that the success of a toothbrush is affected by user technique and that foam swabs are not able to remove plaque from some 'sheltered' areas of teeth. METHODS: A time-series, cross-over controlled trial with 34 volunteers was used to determine the ability of foam swabs and toothbrushes to remove dental plaque which had been allowed to accumulate overnight. Plaque accumulations were scored at each approximal and crevice site for the buccal surfaces of the eight upper and eight lower teeth after each treatment of either toothbrushing or swabbing. RESULTS: Plaque frequency distributions in the form of boxplots, together with results from summary statistics demonstrate that toothbrushes performed substantially better than foam swabs in the ability to remove plaque from the sites studied in this larger sample of people. CONCLUSIONS: The trial verified the findings from the previous study. The conclusions can be generalized to a wider population because of the magnitude and direction of the differences measured. The implications for nurse education and the development of nursing in practice settings include the need to teach effective toothbrushing skills to nurses, and to support clinical staff in developing mouthcare practice, particularly in relation to the use of assessment strategies that include the choice of effective tools.     

Bronchodilators: implications for nursing practice

Beta2-adrenoreceptor agonists are the most widely prescribed bronchodilators and are used for symptomatic control and as 'rescue' medication for people with asthma and other chronic conditions affecting the airways. The authors describe the clinical uses, mechanism of action and potential side effects of these agents, emphasising the nurse's role in monitoring therapy.     

Corticosteroids: implications for nursing practice

Corticosteroids are essential in the management of various inflammatory conditions, but their adverse effects can be a problem. The authors describe the uses and effects of corticosteroids, and discuss the nursing role in minimising problems associated with their use.     

Asperger's syndrome: implications for nursing practice

The most common disorders within the category of Pervasive Developmental Disorders (PDD) are the Autistic Disorders. In the 1994 Diagnostic and Statistical Manual-IV, Asperger's Disorder became a distinct diagnosis within the Autistic category, as part of the disorders first diagnosed in childhood and adolescence. The terms Asperger's Disorder and Asperger's Syndrome are used interchangeably. Attention to and knowledge of Asperger's Syndrome (AS) are necessary to differentiate it from closely related disorders that have overlapping symptoms. There is much discussion about different definitions of Asperger's, different viewpoints of experts in the field, and the diagnostic dilemmas related thereto. Last, and most important, are the nursing implications. Nurses are in a position to identify children with Asperger's early. After identification, the necessary referrals, treatment options, support, and follow-up are essential for these children. Nurses need more knowledge about this disorder and need to be proactive in defining their role to help children with the disorder in the schools and the community.     

Emergency contraception: implications for nursing practice

Emergency contraception is often misunderstood by the general public and nurses alike. This article outlines information about methods of post-coital contraception that all nurses need to provide appropriate health advice to women in any nursing setting.     

Genetics: implications for preventative nursing practice

A method for identifying and evaluating susceptible families for cardiac disease risk is presented from the perspective of the role of genes in heart disease. If useful applications of genetic aggregations could be integrated into nursing practice, preventive selective interventions could be implemented. Nursing practice aimed at risk reduction in susceptible families is more efficient for reducing disease mortality.     

Meaning of spirituality: implications for nursing practice

Background. This research outlines some preliminary findings emerging from a grounded theory investigation into the ‘meaning of spirituality’. These initial results raise some important questions about the terminology and language that nurses use regarding the term spirituality. It seems that many of the policy directives and statutory guidelines make two major assumptions regarding ‘spirituality’. Firstly, patients and nurses are aware and understand the concept, and secondly, patients may require their spiritual needs to be met. These preliminary findings suggest that a dichotomy is emerging between professional assumption and patient expectation regarding the meaning of spirituality. Aim. The study had one broad research aim, to gain a deeper insight into how patients, nurses, and people from the major world religions understand the concept of ‘spirituality’. Design. A qualitative research design was used involving a grounded theory method of inquiry. It was felt that this qualitative method would aid the investigation of this subjective dimension of peoples’ existence, enabling existing theoretical constructs and arguments to be tested. Methods. The constant comparative method was used throughout the data collection and analysis. Analysis was undertaken at two levels, ‘overview analysis’ and ‘line‐by‐line analysis’. This enabled the creation of categories and central themes. Results. Constant comparative analysis resulted in the formation of several categories and central themes. Two categories presented and discussed in detail are ‘definitions of spirituality’, and ‘diverse perceptions of spirituality’. Conclusion. It would seem that there is now an urgent need for nursing to evaluate and perhaps adjust its vision regarding what constitutes spirituality. Such an approach may serve to reduce the gap between policy and public expectation. Relevance to clinical practice. It seems that there may be no ‘precise’ terminology associated with the language used to define spirituality, raising possible implications for nursing practice and nurse education.     

A critical realist approach to knowledge: implications for evidence-based practice in and beyond nursing

This paper will identify some of the key conceptual tools of a critical realist approach to knowledge. I will then apply these principles to some of the competing epistemologies that are prevalent within nursing. There are broadly two approaches which are sometimes distinct from each other and sometimes inter-related. On one side, there is the view that all healthcare interventions should be judged on the principles of randomised controlled trials and the other is a preoccupation with language in which healthcare interventions are subjected to a discursive interrogation. These debates are configured through the idea of a hierarchy of knowledge that is accorded uncritical acceptance by some and virulent distaste by others. I will argue that the notion of hierarchy is problematic and is largely argued for in unproductive epistemological terms. What is required is a shift towards a theory that emphasises the contextual nature of the ways that knowledge is produced and disseminated. In other words, there is no single hierarchy of knowledge, but there are multiple hierarchies of knowledge.     

Enhancing cardiac rehabilitation nursing through aligning practice to theory: implications for nursing education

This article presents a case study that examined the work practice of nurses in a cardiac step-down unit (CSDU). The action research included interviews, participant observation, and a self-reporting questionnaire. Nurses in the unit used a conceptual framework that was inconsistent with the rehabilitation-oriented nursing necessary to enhance patient outcomes in a CSDU. The results of this study show that a need exists for greater alignment between the practice and the educational preparation of nurses who work in a CSDU. A framework such as Dorothea Orem's Self-Care Theory of Nursing (1995) offers a conduit for nurses to deliver care appropriate to CSDU patient needs. However, there is a need for continuing education for nursing staff to align the cardiac rehabilitation nursing philosophy and the theories that underpin it (such as the Self-Care Theory) with nursing practice. Practice development provides a mechanism through which to examine the congruence between patient needs and nurse perception of those needs.     

A review of cervical cancer and cervical screening: implications for nursing practice

In this paper we review epidemiological and other research evidence on cervical cancer and cervical screening We outline recent research evidence implicating sexually transmitted human papillomavirus as one of the causes of cervical cancer, but stress the uncertainty surrounding the causes and natural history of the disease We go on to discuss evidence on risk factors associated with increased incidence of and mortality from cervical cancer, including age, sexual behaviour, smoking, socio-economic status and prolonged use of oral contraceptives Cervical screening has reduced mortality in some countries, and we outline the necessary features of a successful, effective screening programme before going on to describe why screening failed in Britain, at least until the late 1980s Current screening policy is designed to remedy this, and we discuss its implications, and those of previous research, for nursing practice     

Lymphedema and implications for oncology nursing practice

Lymphedema (LE) is described as chronic swelling caused by impairment in lymphatic system drainage. The cause of LE is either primary or secondary (Holcomb, 2006). The experience can be disturbing. Patients and healthcare providers often overlook the initial presentation because of subtle changes. With a basic understanding of LE, oncology nurses can monitor for the presence, educate about preventive measures, and assist in treatment of LE.