Use of a violence risk assessment tool in an acute care hospital: effectiveness in identifying violent patients.

This study examined the use and effectiveness of the Alert assessment form. The form is part of the Alert system, used by one large acute care hospital to identify patients with a propensity for violence. All reported incidents of patient violence from August 1, 2003, through December 31, 2004, were included in patient charts. One hundred seventeen violent patient charts were reviewed and compared with 161 non-violent patient charts, randomly chosen from the same time period. Overall use of the Alert assessment form for violent and non-violent patients was 75.7% and 35.4%, respectively. The assessment form was found to have moderate sensitivity (71%) and high specificity (94%). It is reasonably effective in identifying potentially violent or aggressive patients when it is used according to protocol. Efforts to improve the tool are warranted, as is evaluation of its benefit in settings with low prevalence of violence. Also, greater effort must be taken to prevent violence once an aggressive patient has been identified.     

High resolution solid-state 29si nmr spectroscopy of silicone gels used to fill breast prostheses

We have used ²⁹Si solid-state nuclear magnetic resonance (NMR) spectroscopy to study the chemical structure of the silicone gels in virgin and explanted breast prostheses. Despite evidences of alteration in the morphological appearance of the silicone gel inside the breast prosthesis, our results do not reveal changes in the chemical nature and structure of the silicone gels after implantation. In addition to the main ²⁹Si resonance peak at ?22.26 ppm that corresponds to the resonance frequency of the D repeat unit of the polysiloxane chains, the high sensitivity of our NMR technique allows the detection of very low concentrations of silicone compounds. Within our experimental detection limit of 0.2%, no signal between ?90 ppm and ?150 ppm are observed. This indicates that no silica products are present inside the gel of the prostheses. Furthermore, our ²⁹Si NMR spectra indicate differences in the chemical compositions of the silicone gels from different manufacturers.     

Promotions and relegations in the psychiatric nursing league

This paper describes a complex set of patient and nursing data from 83 psychiatric wards. It explains how the data were collected and organized into a meaningful format using a quality league-table. The patient and nursing characteristics of high quality psychiatric wards ranking above the 74th percentile and the characteristics of low quality wards falling below the 26th percentile are compared and examined in detail. Startling similarities and differences in patient activity, nursing activity, and nursing quality in high and low quality wards are highlighted. Finally, some implications of the findings for nursing practice, management, and education are considered.     

The Stranger

J Emerg Nurs 1998;24:622.     

Elements of psychological support in nursing care

The paper presents the results of a pilot study which involved 50 nurses from several departments of internal medicine of The State Clinical Hospital of the Collegium Medicum, Jagiellonian University in Cracow. The results are based on the Statement Response Questionnaire. They show that the most common responses of the nurses in the face of anxiety expressed by patients are cheering up the patient, collecting information about the symptom, and offering explanation of the symptom. The least common responses included expressing one's own positive emotions and showing empathy towards the patient.