Premature ventricular contraction‐induced concealed retrograde penetration: Electrocardiographic manifestations on anterograde ventricular preexcitation

In patients with manifest anterograde ventricular preexcitation, the electrocardiographic manifestation of the anomalous conduction through the simultaneous conduction over the atrioventricular (AV) node and the accessory pathway (“delta wave”); depends on several factors, the most representative being the conduction velocity over one or another connection. Occasionally, ventricular ectopic beats may present with retrograde penetration over one or both conduction pathways (AV node and/or accessory pathway), impacting on the morphology of the next immediate anterogradely conducted QRS. We present a case of a young patient with WPW syndrome and ectopic ventricular beats with different manifestations on the postectopic QRS due to concealed penetration of different conduction pathways.     

The work style of students of mental health nursing undertaking the Project 2000 schemes of training: a logical analysis

The work methods of students of mental health nursing are analysed to see which are best suited to facilitate the central educational aims of the Project 2000 schemes of training. Supervised primary nursing is found to be best because it engenders a professional cognitive style and a heightened sensitivity to the empirical, research-based culture. It is argued that team nursing causes, in its practitioners, a bureaucratic cognitive style, which acts as a structural constraint upon the learning and mastery of the process skills advocated by the Project 2000 authors.     

Adverse events in health care: a literature review

Aim  This paper aims to develop understanding of the nature, costs and strategies to reduce or prevent a range of adverse events experienced by people within the healthcare system.
Background  Care interventions are not always based on safe practice and adverse events can and do occur that cause or place at risk patients lives and well-being. The nature of adverse events is diverse and can be attributed to a multitude of individual and system contributory factors and causes.
Evaluation  A review of the literature was undertaken in 2006 and 2007 using the following databases: Pubmed, CINAHL, Biomed Ovid, Synergy and the British Nursing Index. This paper evaluates the literature that pertains to adverse events and seeks understanding of this complex issue.
Key issues  Published statistics confirm that globally, professional errors in clinical practice and care delivery occur at an unacceptably high level and result in considerable human and financial consequences.
Conclusion  Reaching understanding of the multiple factors that contribute to unsafe clinical practice situations requires a cultural shift in organizations.
Implication for Nursing Management  Reasons for adverse events are complex and require healthcare managers to evaluate the system issues which impact on the delivery and organization of care.