Development of an Adolescent Inpatient Sexual Abuse Group: Application of Lewin's Model of Change

The development and implementation of an adolescent sexual abuse group on an inpatient psychiatric unit is described. Steps of Kurt Lewin's model of change are used as a framework for this planned change. Specific issues concerning group procedure and process are detailed. Recommendations for this group and broader use of the Lewin model are included.     

The extension of 4 degrees C storage time of frozen-thawed red cells

Blood was drawn from volunteer donors and frozen using the high glycerin, mechanical freezing procedure accepted by the United States Navy. Subsequently, the units of blood were thawed and washed. Various anticoagulants were added, and the red cells were stored in a refrigerator at 4 degrees C for periods of up to 28 days. Chemical analyses were performed periodically. These showed that the addition of the anticoagulants ACD, CPD and CPDA-1 caused the red cells to be preserved better than the currently accepted 0.9-percent NaCl, 0.2-percent glucose solution. In vivo 51Cr viability studies performed on blood stored with CPDA-1 for 14 days showed a 24-hour viability of 78.8 +/- 8.4 percent. In a subsequent study, the blood was stored for 21 days prior to freezing and then was rejuvenated and frozen. The cells were thawed, washed, and stored at 4 degrees C with CPDA-1 for an additional 14 days. The 24-hour viability of these cells was determined to be 74.0 +/- 5.1 percent. These findings show that the postthaw storage time of red cells can be increased greatly over the now-accepted 24 hours, if bacterial sterility can be assured.     

The Need for Operational Definitions for Defining Characteristics

Although much attention has focused on the validation of denning characteristics for nursing diagnoses, equal attention has not been devoted to the development of operational definitions for defining characteristics. Operational definitions, however, provide a reference for determining whether defining characteristics are present in patients who participate in clinical validation studies. Validation of nursing diagnoses emerges from occurrence of the diagnostic label in clinical practice. Operational definitions provide the bridge between incidental observation and scientific validation of nursing diagnoses.