Effect of caffeine on neonatal splanchnic blood flow.

Doppler ultrasound was used to study the effect of the first intravenous dose of caffeine on splanchnic haemodynamics in preterm neonates. Peak systolic velocity in the superior measenteric artery and coeliac axis was significantly reduced for 6 hours after caffeine infusion. The effect of this reduction in blood flow to the neonatal gut is not known.

Evaluation of the fall prevention program in an acute care setting.

PURPOSE: To evaluate the effectiveness of a Falls Prevention Program (FPP) in reducing patient fall rate and to examine predictors of falls. SAMPLE: A nonrandom, stratified convenience sample of 292 subjects was selected from medical-surgical/critical care patients at a large community hospital system. The sample included 101 patients who fell prior to the FPP, 98 patients who fell after FPP, and 93 patients who did not fall after FPP. METHODS: A retrospective, preimplementation/long-term, postimplementation, comparative, descriptive design was used to address differences in patients who fell before and after FPP. Prediction factors associated with incidence of falls were assessed using a sample that included patients who fell and patients who did not fall in 1995. Data were collected about the patients and the fall incidents via a retrospective chart and incident report review. FINDINGS: No decrease in patient fall rate was found between patients who fell before and after implementation of the FPP. Patients tended to fall attempting to get out of the bed, suffering no injury. Model testing of the linear results of patients who fell and patients who did not fall after the implementation of the FPP demonstrated that fall prediction factors included age 60 or over, impaired memory, muscle weakness, and need of ambulatory assistance (Log linear chi-square: 6.048, df 4, p = 0.811 (p > .05). CONCLUSION: Identification of patients who exhibit characteristics of the fall prediction model may be useful in reducing falls in medical-surgical/critical care patients. Further testing of the four-factor model with subsequent inclusion of focused interventions may impact the incidence of falls.

Effect of feed interval and feed type on splanchnic haemodynamics.

AIM: To study the effect of enteral feeding on splanchnic blood flow velocity in preterm infants. METHOD: Coeliac axis and superior mesenteric artery (SMA) blood flow velocity were measured longitudinally in a cohort of 61 babies using Doppler ultrasound. RESULTS: Babies fed 1 hourly had significantly higher preprandial SMA peak systolic velocity (PSV) than those fed 3 hourly (70 vs 53 cm/s). Those fed 1 hourly showed no postprandial change whereas those fed 3 hourly showed significant postprandial hyperaemia. This hyperaemia had longer latency (42 vs 27 mins) and smaller amplitude (31 vs 25 mins) after expressed breast milk compared with preterm formula. The addition of long chain polyunsaturated fatty acids to the formulas had no effect on the postprandial response. CONCLUSION: Hourly bolus feeding leads to a persistent hyperaemic state in the SMA. The composition of feeds is an important determinant of the postprandial response of the SMA to 3 hourly feeding.

An electronic nose to detect changes in perineal odors associated with estrus in the cow.

Changes in perineal odor as estrus is approached could form the basis of a new method of estrus detection. Perineal odor of cyclic cows was monitored. Estrus was identified using ovarian ultrasound, behavioral observations, and plasma assay for progesterone and estradiol. Samples were taken from the dorsal lateral perineal (perivulval) area using cotton bud swabs and presented to an electronic nose. Twelve conducting polymer sensors were used to quantify odor in terms of a change in sensor resistance. Preliminary data (Experiment 1) indicate that the odor signals between the luteal phase and estrus could be distinguished for a group of five cows. In Experiment 2, samples were obtained daily from eight cows during the midluteal phase and from d -2 to d 8 of the cycle (d 0 = day of estrus, induced using cloprostenol). Seven of the eight cows cycled normally. Of the 12 sensors, 7 showed a significant change in resistance that was dependent on the day of the estrous cycle. Basal values were those taken in the luteal phase; values peaked on d -1, rose transiently on d 3, and returned to baseline on d 5 to 6. This pattern is strongly correlated with plasma estradiol concentration. The use of artificial olfaction could enable more accurate detection of estrus and has the potential to increase fertility in cows.

Developing healthcare educators. The application of a conceptual model.

The staff development faculty is a unique group of educators who are at the very core of processes in today's healthcare environment. Even so, little guidance is available for their professional development from novice to expert. The conceptual model presented in this article defines a developmental continuum for healthcare staff educators. The model serves as a comprehensive framework to guide staff development activities from initial orientation to educational opportunities that lead to the expert role.

A cost-effective, unit-based approach to computerized care planning education.

This article describes a grassroots approach to developing an educational program on nursing diagnosis and computerized care planning. The process involved staff nurses in program design, implementation, and evaluation. Using this process, staff development educators will be better able to successfully initiate grassroots programs that educate large numbers of nurses at minimal cost.