A criterion audit of women's awareness of blood transfusion in pregnancy

Background  

In the Confidential Enquiry into Maternal Deaths (CEMD) Report, the very high risk of mortality in women who refuse blood transfusions is highlighted. The objectives were to establish current knowledge about, and views of transfusion in our pregnant population and to establish the level of compliance with the set audit standard.     

Measuring perceptions of the clinical career pathway in a New Zealand hospital

Clinical Career Pathways (CCPs) for nurses were introduced in the 1970s and they were first established in New Zealand during the late 1980s. The implementation of CCP programmes has met with mixed response; many nurses view it negatively as an extra and unnecessary demand from their employers while others perceive it to be a valuable form of professional development. This paper introduces a new instrument, the Clinical Career Pathway Evaluation Tool (CCPET) designed to assess nurses' and midwives' knowledge of and attitudes towards their Clinical Career Pathway. The 51 item instrument takes the form of a self-report questionnaire in two sections. The first tests knowledge of the CCP, as implemented at the study hospital, the second measures attitudes towards CCP and professional development. In this paper we describe the development of the CCPET and present some of the results from an initial application of the instrument with 239 nurses and midwives in a New Zealand hospital. Results indicate that knowledge levels were moderate in this sample and were correlated with both positive and negative attitudes. Results of t-test comparisons indicated that, on average, the group who had already completed a CCP portfolio had greater knowledge and more positive attitudes than the group who had not. The authors suggest firstly that the CCPET is useful for measuring CCP knowledge and attitudes in a constantly restructuring nursing environment, and secondly that the instrument can be easily adapted for use in other hospitals and organisations.     

Critical elements of documentation for data-based research

Scientific integrity and progress are enhanced by precise documentation of the conceptual development and information management aspects of research. Careful and complete documentation of the research process supports accurate reporting. The exercise of documenting data management activities provides an opportunity for nurse researchers to reflect on a study to guide current work and inform and enhance future research. The literature includes many references to the need for data management but contains little advice regarding the nuts and bolts of documenting data management activities. This article describes specific steps for documenting data-based research beginning with the study design and ending with data analysis. The documentation framework and examples presented are sufficient to guide the comprehensive record keeping required for complex studies and can be modified to meet the simpler needs of smaller research projects.     

Gendered cybersupport: a thematic analysis of two online cancer support groups

Within the last few years numerous support groups have emerged on the Internet, presenting new opportunities for patients to communicate with health care professionals and other patients. The present study examines discourse within online cancer support groups, increasing our understanding of sex differences in cybersupport. Two reproductive cancer groups were chosen for this investigation, the Ovarian Problems Mailing List (OPML) and the Prostate Problems Mailing List (PPML), making sex of the patient recognizable. Phenomenological thematic analysis was employed to describe and interpret messages sent and received. Analyses for the two groups were compared. Generally, it was found that the two online listservs provided opportunities for cancer patients to receive support, within western society's accepted forms of gendered communication.     

Accounting for flow dependence of respiratory resistance during exercise

Studies of airway function during exercise have produced conflicting results both in healthy and diseased subjects. Respiratory resistance (Rrs) was measured using an impulse oscillation technique. A flow/resistance curve was established for each of 16 healthy males during voluntary hyperventilation (VHV) at rest. Then, Rrs and flow were measured immediately (t(0)) and 90 sec (t(90)) after exercise on a cycle ergometer at 60, 70, and 80% of maximal aerobic power. The flow/resistance relationship at rest during VHV was used to assess the flow dependence of Rrs. Rrs at t(0) was higher than at rest (P <0.01) but lower than Rrs obtained at matched flow during VHV (P <0.05). In healthy subjects, the linear increase in Rrs with VHV indicates airflow dependency of Rrs following Rohrer's equation. The relative decrease in Rrs with exercise suggests bronchodilation. The bronchodilating effect disappeared promptly when exercise was stopped suggesting that it may have been related to a reflex mechanism.     

Routine questioning about non-consenting sex: a survey of practice in Australasian sexual health clinics

The objectives of the study were, 1. To ascertain if sexual health physicians and practitioners believe a question concerning a past history of non-consensual sex should be asked routinely and are asking it. 2. To identify whether sexual health services have established protocols to integrate this question into practice. 3. To identify the barriers to this becoming part of a routine sexual health history. A questionnaire covering demographics, protocols and practice around asking the question and reasons for not asking was sent to all (20) sexual health clinics in New Zealand and 7 sexual health clinics in Australia, inviting participation from all staff who took routine sexual health histories. Twenty-seven sexual health clinics participated with a total of 122 (69% response rate) questionnaires completed and returned. One hundred and thirteen (93%) participants believed it was a relevant question to ask. Seventy-eight (63%) said asking the question was encouraged, and routinely or mostly asked the question. Only 40 (33%) identified their workplace had a written policy and 52 (43%) had not received specific training in asking the question. The majority who asked routinely said their client never or rarely objected and that it did not often add significantly to the time. The main reasons for not asking were the belief it was nothing to do with the person's presenting complaint, concern the client would find it too disturbing, inadequate training, and lack of time. Sexual health clinics should develop protocols and guidelines and provide appropriate training to ensure that routine questioning about non-consenting sex is integrated into safe practice.