Smoking behavior and the efficacy of nurses as role models.

The smoking cessation and prevention issue has not been addressed by nurses, the largest group of health care professionals in the nation (1.4 million currently licensed to practice). The World Health Organization and the Centers for Disease Control acknowledge smoking as the "single most preventable cause of poor health in the world," but not a solitary continuing medical education course of the 9,000 available in the United States in 1983 dealt with ways to resolve this issue. The women's movement has not addressed this cause, and nurses, a predominantly female population, continue to smoke in alarmingly large numbers, causing doubt as to nurses' effectiveness n teaching prevention or cessation. Nurses as role models could be crucial in effecting change in the smoking behavior of the general population, thereby eliminating or greatly reducing the health risk. There appears to be a significant need for more effective educational programs concerning the health hazards of smoking for all nurses and nursing students if the potential power of nursing leadership is to be realized in reducing mortality and morbidity from the number one killer in America.

Hospital readmissions among survivors six months after myocardial revascularization.

One neglected but important measure of early morbidity after coronary artery bypass graft (CABG) operations is rehospitalization. As part of a prospective study of recovery after elective CABG procedures conducted at four academic medical centers, data from all readmissions occurring within the first six postoperative months were collected for 326 patients. A total of 24% of patients had readmissions. The most common categories of readmission discharge diagnoses were cardiac (57%), noncardiac (26%), and surgical sequelae (17%). Factors from the initial hospitalization identified as risk factors for rehospitalization included: length of stay in intensive care unit after surgery, severe noncardiac complications, duration of preoperative cardiac symptoms, intra-aortic balloon insertion, and preoperative resting angina. These findings help to identify a subset of at risk patients for whom more careful surveillance might be beneficial.