Do basic auscultation skills need to be resuscitated? A new strategy for improving competency among nursing students.

BACKGROUND: Auscultation of heart and lung sounds is a foundational competency for Registered Nurses (RNs). Precise and timely assessments are important for the early detection and recognition of the deteriorating patient. Studies have shown that improved teaching methods that incorporate emerging technologies and address different learning styles are needed to improve competency in auscultation. METHOD: Undergraduate nursing students (n = 127) were randomized into treatment and control groups. The control group received the usual preparation in auscultation learning strategies. The treatment group received the usual training plus three auscultation learning sessions that were each 2 h in length (cardiac, pulmonary and mixed sounds). RESULTS: The virtual auscultation teaching strategy had a significant impact on undergraduate nursing student's competency in recognizing heart murmurs. The treatment group also had increased scores compared to the control group increased scores in distinguishing normal versus abnormal heart and lung sounds, identification of crackles and diminished breath sounds. CONCLUSION: Virtual auscultation as a teaching strategy was shown to have a positive impact on undergraduate student nurse competence in accurately identifying heart and lung sounds.

Factors associated with unplanned readmissions following cardiac surgery.

Cardiac surgery patients are at risk for unplanned readmissions due to the various complications they may experience following surgery. The purpose of this report is to critically review the literature related to predictors of unplanned readmissions of cardiac surgery patients following discharge from the hospital. A literature review was conducted from 1989 to 1999 using MEDLINE and CINAHL, with the following key words: cardiac surgery, coronary artery bypass surgery, recovery, and readmission. The literature revealed that gender and race do have an effect on how well a patient will recover following cardiac surgery. It was also found that patients with longer lengths of stay due to complications were at greater risk for readmission following discharge from the hospital. There was no evidence that decreased length of stay for this patient group led to a greater number of readmissions. Implications for nurses include the need for improved coordination of patient care and implementation of effective discharge planning in high-risk patients. Additional research is needed to develop interventions to decrease readmissions of women and African Americans and other racial groups specific to their particular risk factors for readmission following cardiac surgery.