Graduated compression stockings: updating practice, improving compliance

Graduated compression stockings (GCS) have long been used to prevent deep venous thrombosis in hospitalized patients. The validation of published research findings regarding the use of GCS, and the implementation of practice changes pertinent to medical-surgical nursing are examined.

Caring Behaviors Inventory: analysis of responses by hospitalized surgical patients

Hospitalized surgical patients were surveyed to determine the completeness, reliability, and validity of their responses to the 42-item Caring Behaviors Inventory (CBI) and to an abbreviated inventory derived from it. Of 354 patients, 211 completed all 42 CBI items. Item responses were reliable (alpha = 0.980) and each correlated (r = 0.192-0.630) with global nurse caring (GNC). The CBI score (item sum) also correlated with patients' rating of GNC (r = 0.569). All CBI items correlated with the CBI score (r = 0.582-0.863). Forward multiple regression showed 6 items (6, 13, 16, 28, 33, and 41) to explain nearly all variance in the CBI score (R = 0.979). Responses to these 6 items by 318 patients were reliable (alpha = 0.893); their sum was correlated with the CBI score (r = 0.964) and patients' rating of GNC (r = 0.605). This study provides further statistical support for the CBI. It justifies use of a less burdensome 6-item inventory.

Ethics in perioperative practice--commitment to the patient

Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this fourth of a nine-part series that will help perioperative nurses relate the ANA code to their own area of practice, the author looks at the second statement, which emphasizes commitment to the patient.

Guidance for the psychological care of day case surgery patients

An increase in day surgery activity to 75 per cent of all elective surgery is a central feature of the NHS Plan (DoH 2000). However, patient information provision remains a challenge for all modern surgery as the time spent in hospital is brief and the level of self-care has grown. Effective information provision and an increased emphasis on psychological care are therefore essential to the future of day surgery.

Reprocessing single-use devices--the equipment connection

This is the second in a series of three articles about reprocessing medical devices labeled as "single use" by the manufacturer. The goal of reprocessing single-use devices (SUDs) is to save money and decrease environmental pollution. Reprocessing can be performed on SUDs that have been used on other patients or opened but not used. In this article, the procedures for reprocessing (e.g., cleaning, inspecting, sterilizing, tracking, testing, validating) and establishing a reuse program are discussed. The first article of the series, published in the May 2002 issue of the Journal, discussed the ethical component of reusing SUDs. The third article, to be published in the July 2002 issue, will discuss the roles of the involved regulatory agencies and organizations guiding the process.

Evidence-based practice guidelines--one way to enhance clinical practice

Abdominoplasty and liposuction guidelines are just two of the guidelines that can be accessed and used to enhance patient care. Guidelines also can be used to increase your knowledge about many other health care topics. The NGC has approved guidelines for managing chronic pain, as well as guidelines on chronic diseases (e.g., diabetes mellitus, hypertension, chronic obstructive pulmonary disease). Many patients have chronic diseases, and you or your family members also may be affected by chronic disorders. These guidelines provide you with a quick overview of evidence-based treatment protocols. These guidelines are not a panacea for evidence-based practice, but using them is one way that perioperative nurses can enhance their clinical skills. Though not everyone has personal Internet access, most health care facilities do or can make access a reality. Other options include medical or public libraries. Then one simply has to access the NGC web site and join other professionals in improving the quality and timeliness of patient care.

Ethics in perioperative practice--accountability and responsibility

Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this third of a nine-part series that will help perioperative nurses relate the ANA code to their own area of practice, the author looks at the fourth provision statement, which addresses nurses' accountability and responsibility.

Preoperative hair removal--a systematic literature review

This article describes a systematic literature review on whether, how, and when to perform preoperative hair removal. By searching electronic databases and reference lists of relevant articles, team members identified 20 clinical studies that deal with preoperative hair removal. No strong evidence was found to advocate against preoperative hair removal. Furthermore, there was strong evidence to recommend that when hair removal is considered necessary, shaving should not be performed. Instead a depilatory or electric clipping, preferably immediately before surgery, should be used.

Reprocessing single-use devices--the ethical dilemma

This is the first in a series of three articles about reprocessing medical devices labeled as "single use" by the manufacturer. The goal of reprocessing single-use devices (SUDs) is to save money and decrease environmental pollution. Reprocessing can be performed on SUDs that have been used on other patients or opened but not used. The practice of reprocessing is complex and technical, and it raises concerns about patient safety, ethics, the environment, and costs. Opponents of reprocessing argue that the risks outweigh the benefits and that research has not proven it to be safe. Supporters believe the devices are labeled for single use so that manufacturers can maintain their profit margin and avoid liability. The purpose of part one of this article is to inform nurses about the ethical issues, patient safety issues (e.g., infection control, patient injury), and previously performed research studies regarding reprocessing and reusing products that are intended for single use. The second and third articles in this series will discuss procedures for reprocessing, roles of the regulatory agencies involved, and advantages and disadvantages of using third-party reprocessors.

Ethics in perioperative practice--patient advocacy

Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this second of a nine-part series that will help perioperative nurses relate the ANA code to their own area of practice, the author looks at the third provision statement, which addresses nurses' position as patient advocates.

Ethics in perioperative practice--principles and applications

Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this first of a nine-part series that will help perioperative nurses relate the ANA code to their own area of practice, the author looks at the first statement, which emphasizes respect for people.