Recent progress in cardiac nursing and rehabilitation programmes

The value of coronary care units in reducing mortality has been questioned in recent years. However, nurses working in such units have acquired considerable specialist knowledge about coronary artery disease and the psychological problems of patients requiring intensive care. During the 1970s several formal studies of patient management and secondary prevention were developed and reported by nurses. In this review these findings and their effects on patients, relatives and nursing staff are discussed.     

Processes in the creation and diffusion of nursing knowledge: an examination of the developing concept of family-centred care

The creation of a knowledge base to underpin and direct nursing practice has been the pursuit of nurse academics, educationists and practitioners over recent decades Much of this work has concerned the explication of major theories of nursing, whilst some has sought to elucidate specific areas of knowledge This paper outlines processes of creation and diffusion, considering the influence of factors from both within and without the nursing profession on the epistemology of its knowledge base An examination of the developing concept of family-centred care is utilized to illustrate the convolutionary process of knowledge creation     

Recovery from anaesthesia in children

There are no published comprehensive surveys of paediatric recovery room experience and the incidence of complications. A prospective survey was made of 16,700 consecutive admissions to the recovery room at the Royal Manchester Children's Hospital during the years 1985-1988. The incidence of respiratory complications was low, with laryngospasm 0.85%. The incidence of hypotension was higher than that in adult studies; over 50% of children recorded a decrease in blood pressure in the recovery room of more than 20%, compared to values before operation. The incidence of vomiting in the recovery room was also lower than in comparable adult studies. Certain aspects of recovery room practice changed during the 4 years of the study; these included routine oxygen administration, parents in the recovery room, and our approach to postoperative analgesia. The implications of these changes are discussed.     

Development and evaluation of a specifically designed website for haematopoietic stem cell transplant patients in Leeds

The purpose of this project was to develop and evaluate a specifically designed website (ALLograft INformation EXchange – ALLINEX) for adult allogeneic haematopoietic stem cell transplant (allo‐HSCT) patients in Leeds. Specifications included information on the transplant journey and supportive care services, discussion forum and patient‐clinical team electronic messaging service. The method followed a participatory action research approach in a five‐phase project involving stakeholders. Phase 1 involved information gathering; Phase 2 development of content; Phase 3 building of website and usability testing; Phase 4 preliminary evaluation; and Phase 5 clinical implementation. Results concluded that Phase 1 patients were unaware of all services and reported unmet needs; gaps in support services were identified from a service evaluation; Phase 2 content was collected from experts, collated and synthesised; Phase 3 patient and staff feedback was positive and constructive resulting in more than 50 changes; Phase 4 ALLINEX evaluation demonstrated acceptable usability with good layout, content and aesthetics reported; Phase 5, over 15 weeks, ALLINEX had 6630 page hits, 9 new forum topics posted and received 3 clinical messages. The clinical team embraced responsibility for reviewing and monitoring ALLINEX. Financial and indemnity cover was secured for 3 years. ALLINEX, adopted locally, is sustainable and has functionality to roll‐out to other UK allo‐HSCT centres.     

Parent views of infant pain and pain management in the neonatal intensive care unit

It is well established that infant pain is an important concern of parents, but little is known about the knowledge and expectations of parents regarding their infant's pain or about parents' involvement in their infant's care and satisfaction with pain management by neonatal intensive care unit (NICU) staff. Parents have an important role to play in helping health care professionals understand their child's pain and in providing comfort to their child. Neonatal nursing has been at the forefront of family-centered care, but family involvement in pain care has lagged behind other aspects. New guidelines and standards emphasize the importance of the family's role in pain management. This article examines the rationale for supporting parent involvement in infant pain care and discusses the importance of understanding parent views on infant pain in light of the new standards for pain management set forth by the Joint Commission on Accreditation of Healthcare Organizations. Findings from a survey to determine parent understanding of and involvement in infant pain care in one NICU are presented. A continuous-quality-improvement approach for enabling the involvement of parents in their infant's pain care is proposed, and specific strategies are suggested. Copyright © 2001 by W.B. Saunders Company     

Fetal home telemetry

A simple method whereby the fetal heart rate can be monitored in hospital while the mother is sitting at home has been developed. This paper describes a feasibility study undertaken to assess the practicality of its use.     

A holiday break for adolescents provided by the Malcolm Sargent cancer fund for children

The paper describes a holiday for a group of adolescents with cancer (from the Young Oncology Unit at the Christie Hospital, Manchester, UK) at Malcolm Sargent House, Prestwick, Scotland. The aim was to provide an opportunity for young people with cancer to build and to develop therapeutic relationships away from the pressures of hospital, home and treatment. The nature and range of care given by the nurses and social worker who accompanied them is described and includes accounts of individual progress which are demonstrated by brief case studies.