Addressing the mental health nurse shortage: Undergraduate nursing students working as assistants in nursing in inpatient mental health settings

The population of mental health nurses is ageing and in the next few years we can expect many to retire. This paper makes an argument for the employment of undergraduate nursing students as Assistants in Nursing (AINs) in mental health settings as a strategy to encourage them to consider a career in mental health nursing. Skill mix in nursing has been debated since at least the 1980s. It appears that the use of AINs in general nursing is established and will continue. The research suggests that with the right skill mix, nursing outcomes and safety are not compromised. It seems inevitable that assistants in nursing will increasingly be part of the mental health nursing workforce; it is timely for mental health nurses to lead these changes so nursing care and the future mental health nursing workforce stay in control of nursing.     

The extract of Mucuna pruriens possesses histamine activity

ObjectiveTo investigate the activity of the active principle in the spines of the seed pods of Mucuna pruriens using contraction of guinea pig ileum as index of pharmacological activity.MethodsThe active principle was extracted with 0.0015 M NaCl. Muscle strips of guinea pig ileum were prepared and contractile responses were measured using a Kymograph. Two sets of experiment were conducted: (1). The contraction of the ileum in presence of different concentrations of histamine, 2-methylhistamine and the extract of Mucuna pruriens. (2). The contractile response of the ileum in presence of different concentrations of the extract and antagonists including diphenhydramine, atropine and methysergide.Results(1) The extract of Mucuna pruriens hair, 2-methylhistamine and histamine produced dose dependent contraction of guinea pig ileum (Extract ED₅₀ = 13.0 μg/mL, 2-methylhistamine ED₅₀ = 8.5 μg/mL and histamine ED₅₀ = 10.0 μg/mL). (2) Diphenhydramine, an H₁ antagonist competitively blocked the contractile response of the Mucuna pruriens extract. (3) Coadminstration of the Mucuna pruriens extract either with different doses of antimuscarinic agent atropine or 5-hydroxytryptamine blocking agent methysergide did not alter the extract induced contractile response of the guinea pig ileum.ConclusionThese results demonstrate that the spines of Mucuna pruriens possess histamine activity which may contribute to its itching and painful irritation effects.     

Do Gerontology Nurse Specialists Make a Difference in Hospitalization of Long‐Term Care Residents? Results of a Randomized Comparison Trial

Residents of long‐term care facilities have highly complex care needs and quality of care is of international concern. Maintaining resident wellness through proactive assessment and early intervention is key to decreasing the need for acute hospitalization. The Residential Aged Care Integration Program (RACIP) is a quality improvement intervention to support residential aged care staff and includes on‐site support, education, clinical coaching, and care coordination provided by gerontology nurse specialists (GNSs) employed by a large district health board. The effect of the outreach program was evaluated through a randomized comparison of hospitalization 1 year before and after program implementation. The sample included 29 intervention facilities (1,425 residents) and 25 comparison facilities (1,128 residents) receiving usual care. Acute hospitalization rate unexpectedly increased for both groups after program implementation, although the rate of increase was significantly less for the intervention facilities. The hospitalization rate after the intervention increased 59% for the comparison group and 16% for the intervention group (rate ratio (RR) = 0.73, 95% confidence interval (CI) = 0.61–0.86, P < .001). Subgroup analysis showed a significantly lower rate change for those admitted for medical reasons for the intervention group (13% increase) than the comparison group (69% increase) (RR = 0.67, 95% CI = 0.56–0.82, P < .001). Conversely, there was no significant difference in the RR for surgical admissions between the intervention and comparison groups (RR = 1.0, 95% CI = 0.68–1.46, P = .99). The integration of GNS expertise through the RACIP intervention may be one approach to support staff to provide optimal care and potentially improve resident health.     

自体骨软骨镶嵌移植术修复关节软骨缺损

目的：回顾性分析关节镜下自体骨软骨镶嵌式移植术治疗负重面关节软骨损伤的可行性。方法：采用Smith Nephew镶嵌式骨软骨移植器，在关节镜下挖取膝关节非负重关节面骨软骨条，并将之移检修复膝关节负重面的局灶性软骨缺损。结果：手术15例，术后随访7—12个月，平均9个月，均达到优良效果。结论：自体关节骨软骨镶嵌移植术对关节负重面局灶性软骨缺损有较好、确实的治疗效果。