Decrease new graduate nurse orientation costs by using HESI exit exam scores

Predicting workplace success is becoming increasingly important because the cost of orienting new nurse graduates is increasing at such an alarming rate. This study assessed the effectiveness of the HESI Exit Exam in measuring entry-level competencies of novice nurses. Findings indicate that the HESI Exit Exam was an effective predictor of workplace competency for new graduates (N = 108) assigned to acute care and critical care units in a large, tertiary care hospital.     

Journal keeping as an educational strategy in teaching psychiatric nursing

Personal attitudes and self-awareness are key issues of which the psychiatric nursing student must be aware when establishing a therapeutic relationship Facilitating awareness and growth in these areas are fundamental challenges for the nurse educator One potential teaching strategy with which to address this issue is journal keeping This paper describes a study evaluating the impact of journal keeping on student nurses' attitudes toward psychiatric clients and self-awareness in relations with others Third-year nursing students completing a psychiatric rotation kept journals which were used to reflect on thoughts and feelings engendered by their clinical experience Two student control groups were used one completing a psychiatric rotation without keeping journals and the second completing a medical-surgical rotation All students completed the Opinions About Mental Illness, the Fundamental Interpersonal Relations Orientation-Behaviour, and Comfort in Working with Psychiatric Clients Scales prior to and at the end of their clinical experience Findings support the use of journals to assist students in exploring and changing their attitudes but not necessarily in changing their interpersonal style     

Immunoglobulin G levels during collection of large volume plasma for fractionation

Background

There is a need of comprehensive work dealing with the quality of plasma for fractionation with respect to the IgG content as today most plasma derivates are used to treat patients with immunodeficiencies and autoimmune disorders. Therefore, a prospective study was carried out to analyse IgG levels before plasmapheresis and every 200 ml collected plasma.

Menopause Management Knowledge in Postgraduate Family Medicine,Internal Medicine,and Obstetrics and Gynecology Residents: A Cross-Sectional Survey

Objective

To evaluate the knowledge of and nature of training for menopause management in postgraduate residents.

Two computer-based anesthetic monitors: The duke automatic monitoring equipment (Dame) system and the microdame

From 1972 to 1983 the Duke University Department of Anesthesiology designed, built, and maintained most of its own operating room patient monitoring equipment. Construction of a new hospital facility in 1980 provided the opportunity to design and test a new computer-based system, the Duke Automatic Monitoring Equipment (DAME) System. The system consists of microcomputer-based instrumentation on monitoring carts, which communicate with a central minicomputer that allows selection ot different software monitoring packages based on the needs of the patient. Multiple problems, including frequent total monitoring failures during surgery, plagued the DAME System in its first year of operation. Despite resolution of many of these problems, user acceptance was poor because of the large size and weight of the monitoring carts, the inadequate quality of displayed physiological waveforms, and inability to overcome the difficulties of the man-machine interface. Because the remaining problems could not be rectified with the existing monitoring carts, a new generation of monitors was designed. The smaller, multiprocessor microDAME was designed to be as automatic and user tolerant as possible. It would omit much of the flexibility that had proved undesirable in the DAME system. When the microDAME was nearly completed, however, departmental research in that area ceased. It remains for others to apply our experiences to further improve operating room patient monitors.     

New dip-and-read test for determining leukocytes in urine

A new reagent strip for the determination of leukocytes in urine (LEUKOSTIX; Ames) is described. The test is based on the esterase activity in leukocytes as a marker. Upon contact between the reagent matrix and a urine containing leukocytes, an amino acid ester is hydrolyzed by the esterase to its corresponding alcohol. The free alcohol then couples with a diazonium salt to produce a purple azo dye. The relative concentration of leukocytes in the urine is obtained by visually comparing the strip reaction with a color chart. Performance of the strip was evaluated in a clinical study involving eight different sites and 867 urine specimens. The comparison method was sediment microscopy; specimens containing five cells or more per high-power field were considered to be positive. Sensitivity was 76.3%, specificity 80.8%. Performance was comparable with that of the CHEMSTRIP LN (Boehringer-Mannheim Diagnostics, Inc.) leukocyte test, which we evaluated concurrently.     

Analytical and clinical evaluation of the Bayer ADVIA Centaur automated B-type natriuretic peptide assay in patients with heart failure: a multisite study

BACKGROUND: B-Type natriuretic peptide (BNP) is released from the left ventricle of the heart into the circulation in response to ventricular stretching and volume overload. Increased BNP concentrations are associated with heart failure (HF). METHODS: We evaluated the analytical and clinical performance of the Bayer ADVIA Centaur BNP assay. Studies included precision, analytical correlation (against the Shionogi ShionoRIA and Biosite Triage BNP assays), BNP results for blood collected in plastic tubes containing EDTA vs other collection tubes, high-dose hook effect, detection limits, and interferences. The clinical performance was tested on 2243 blood samples collected from 983 apparently healthy individuals, 538 patients with chronic disease but without HF (renal insufficiency, chronic obstructive pulmonary disease, diabetes, and hypertension), and 722 patients with HF (New York Heart Association classes I-IV). RESULTS: The ADVIA Centaur assay had total imprecision (CV) of 3.4%, 2.9%, and 2.4% at BNP concentrations of 48, 461, and 1768 ng/L, respectively. The Passing-Bablok correlations to the ShionoRIA and Triage were as follows: ADVIA Centaur = 1.11(ShionoRIA) - 1.19 ng/L (r = 0.98); ADVIA Centaur = 0.78(Triage) + 5.89 ng/L (r = 0.92), respectively. Of the different blood collection tubes, only EDTA plastic tubes (with and without the barrier gel) were acceptable. The lower detection limit was 0.5 ng/L, and there were no interferences from common analytes, other neuropeptides, or unusual antibodies. BNP exhibited different reference intervals according to age and gender. BNP concentrations increased progressively as the severity of HF increased. CONCLUSIONS: The ADVIA Centaur is the first commercially available BNP assay for use on an automated immunochemistry platform. This assay has good analytical and clinical performance characteristics for diagnosing HF.