Neonatal nurses' knowledge of and attitudes toward caring for cocaine-exposed infants and their mothers.

The knowledge, attitudes, and backgrounds of 215 nurses employed in the nurseries of six hospitals were studied by means of a questionnaire survey. The nurses' attitudes toward the mothers of cocaine-addicted infants were found to be generally negative and/or judgmental and their knowledge to be low. More experience with nursing cocaine-addicted infants and greater acuity of the neonatal unit in which the nurse worked correlated with more positive attitudes toward the infants but not toward their mothers. Knowledge and attitude correlated positively with formal education, inservice education, and self-education, but the correlations were weak.

Fascial closure of laparoscopic port sites: a new technique.

The laparoscopic operative procedure is not complete until the port sites are closed with a fascial suture. Herein, we report a simple new technique that uses a venous catheter for suture placement and direct laparoscopic visualization to secure the abdominal wall fascia and peritoneum.

Nursing administrators' perceptions of critical care CNSs.

The literature has demonstrated inconsistencies among nursing administrators in their perceptions of the CNS role functions. Nursing administrators from 198 hospitals were surveyed: (a) to determine the current use of the critical care CNS, (b) to identify the importance placed on the critical care CNS role functions (expert clinician, educator, consultant/change agent, researcher, manager), (c) to ascertain perceptions of specific activities related to each role function, and (d) to determine any differences in perception of role functions between administrators who employed critical care CNSs and those who did not. Nursing administrators who employed critical care CNSs ranked the role of expert clinician as most important, followed by educator, consultant/change agent, and researcher. The role of manager was ranked least important. Nursing administrators who did not employ critical care CNSs ranked the roles in the following order of importance: expert clinician, educator, consultant/change agent, manager, and researcher.

Phototherapy in the home setting.

Physiologic jaundice is a self-limiting process affecting approximately 50% of normal-term infants during the first week of life. Phototherapy has proven to be effective in reducing or preventing the rise in bilirubin levels in the newborn when it is related to this natural process. However, phototherapy generally prolongs the length of hospital stay for the jaundiced newborn. The trend toward early discharge and the increase in the availability of highly sophisticated technical equipment designed for home use affords the family the opportunity to actively engage in the decision to take their child home early, thus reducing expenses and time spent in the acute care setting. Home care also allows the family to stay together while caring for the jaundiced newborn and promotes early bonding of all family members, including siblings. This article presents an overview of home phototherapy, focusing on the role and responsibility of the nurse and education of the parent/caretaker.

The use of scintiangiography with technetium 99m in the diagnosis of traumatic pseudoaneurysm.

Pseudoaneurysm formation is a known complication of peripheral arterial access procedures. Although standard contrast angiography has been considered the diagnostic study of choice to identify pseudoaneurysms, isotope angiography has been described as an alternative method. In this study, we examined the role of 99mTc-tagged red blood cell scans in the diagnosis of traumatic pseudoaneurysm. Forty patients underwent scans; 25 scans were reported as abnormal and 15 as normal. There were no false-negative results; one scan had false-positive results (2.5%). The presence of pseudoaneurysm among the patients with abnormal scans was verified at operation in 23 of 25 patients. The one false-positive test was verified by ultrasound. All patients with normal scans were followed up for verification. Follow-up time ranged from 2 to 28 months. Radionuclide vascular flow study appears to give information similar to that of conventional angiography. With a series false-positive rate of 2.5%, the examination has a high specificity. The 99mTc-tagged red blood cell scan is a viable alternative to conventional angiography for the diagnosis of traumatic pseudoaneurysms and is associated with less radiation and morbidity.