A comparison of the stressors experienced by parents of intubated and non-intubated children

When children are ill enough to require admission to paediatric intensive care, parents may become distressed about their child's medical condition and this distress may be compounded by the unfamiliar nature of the highly technological environment Parents of children who are sick enough to warrant intubation are particularly likely to be exposed to a frightening array of technological equipment Seventy-one parents of intubated and non-intubated children completed the Parental Stressor Scale Paediatnc Intensive Care Unit (PSS PICU) Overall the findings suggest that parents were most distressed (a) by the painful procedures to which their children were subjected, (b) by the sights and sounds of the intensive care unit and (c) by their children's reactions to intensive care The behaviour of staff towards parents and the way that staff communicated with them caused the least distress When the levels of stress reported by parents of intubated children were compared with those reported by parents of non-intubated children, different patterns of stress were found Painful procedures were a source of greater stress to parents of intubated children whereas the behaviour of staff and the children's reactions to the intensive care experience caused greater stress to the parents of the non-intubated children In general the findings suggest that the needs of parents of non-intubated children are being overlooked, with staff focusing more of their attention on the parents of intubated children     

Diploma-prepared nurses' use of technological equipment in clinical practice

Increasingly, nurses throughout the western world are receiving their educational preparation for initial registration in a tertiary environment at either the diploma or bachelor degree level The length of time spent in the clinical setting has been reduced considerably, with the elimination of the apprenticeship system and the role of the student nurse as paid staff member Concurrently, the amount of technological equipment used in the health care sector is both increasing rapidly and now found in general wards, not just the traditional 'high tech' environments It is important to evaluate how well the tertiary experience prepares students in terms of their ability to handle common technological equipment such as infusion control devices or suction pumps In the study reported here 245 diploma-prepared registered nurses completed a questionnaire designed to assess how nurses from tertiary institutions perceived their ability to handle technical equipment in the workplace The majority of the respondents had been working for 7 to 12 months No significant relationship was found between the frequency of use of specific items of clinical equipment and whether that item caused the nurse concern in practice There was also no significant relationship between the frequency of use of an item and whether participants believed that competence should be acquired in relation to that item prior to tertiary graduation Although moderate levels of comfort in the use of technical equipment were reported upon entry to the workplace, subjects rapidly acquired high levels of comfort in relation to equipment handling The implications for hospital administrators and tertiary teaching programmes are discussed     

Global Health and Emergency Care: A Resuscitation Research Agenda—Part 2

At the 2013 Academic Emergency Medicine global health consensus conference, a breakout session to develop a research agenda for resuscitation was held. Two articles are the result of that discussion. This second article addresses data collection, management, and analysis and regionalization of postresuscitation care, resuscitation programs, and research examples around the world and proposes a strategy to strengthen resuscitation research globally. There is a need for reliable global statistics on resuscitation, international standardization of data, and development of an electronic standard for reporting data. Regionalization of postresuscitation care is a priority area for future research. Large resuscitation clinical research networks are feasible and can give valuable data for improvement of service and outcomes. Low‐cost models of population‐based research, and emphasis on interventional and implementation studies that assess the clinical effects of programs and interventions, are needed to determine the most cost‐effective strategies to improve outcomes. The global challenge is how to adapt research findings to a developing world situation to have an effect internationally.     

A Heideggerian hermeneutic study of the practice of critical care nurses

This study provides a Heideggerian analysis of the practice of eight critical care nurses who work in an Australian intensive care unit Specifically, it describes two themes that emerged from a larger study on expert critical care nursing practice These themes are referred to as 'balancing' and 'being busy' Each theme emerged with several foci The theme 'balancing' is concerned with the ability of the nurse to manage simultaneously the paradoxical relationship between the technology of the intensive care unit and the processes of care 'Being busy' was a theme that recognized the technical nature of critical care nursing The paper concludes with a discussion of the relevant Heideggerian philosophical concepts     

A failed fall prevention study in an acute care setting: Lessons from the swamp

Designing and implementing fall intervention studies in acute care settings presents researchers with a number of challenges. To date, there are no fall prevention interventions that have unequivocal empirical support in these settings. Based on the best available evidence a multistrategy fall prevention program was implemented using a pretest-post-test design over a 12-month period. The results indicated no reduction in the fall rate. Contrary to the expected result, the fall rate increased post the implementation of the multistrategy fall prevention program. To assist other researchers understand the contextual and methodological barriers to conducting fall prevention research in acute care settings, this paper discusses the difficulties experienced in this study.