A randomised controlled trial comparing the use of manual versus mechanical compression to obtain haemostasis following coronary angiography.

Cardiac interventions have become a commonly accepted treatment option for patients with coronary heart disease. Managing the arterial puncture site and femoral sheath removal is an important aspect of cardiac nursing practice for patients who have had cardiac diagnostic and interventional procedures. The purpose of this study was to compare the use of manual compression with a mechanical compression device in achieving haemostasis after femoral sheath removal in coronary angiography patients and to determine the ability of these two techniques to reduce groin complications. A randomised controlled trial comparing two compression protocols (manual and QuicKlamp) was undertaken on a sample of 100 patients scheduled to have coronary angiography. Descriptive statistics were used to analyse and describe the data. Inter-group comparisons were analysed using either Chi-squared analysis for nominal data, or the Mann-Whitney U-test for continuous variables. The results indicated that the QuicKlamp device took longer to effect haemostasis after femoral sheath removal (P=0.000) and subjects took longer to mobilise than after manual compression (P=0.001). More haematomas occurred following manual compression after pressure dressing removal (P=0.027). At 5-day follow-up, more bruising was identified in those subjects in the QuicKlamp compression group (P=0.046), as was swelling in female subjects (P=0.044). More episodes of chest pain at 5-day follow-up were identified in the manual compression group (P=0.014). The findings demonstrate that QuicKlamp mechanical compression is a safe alternative to manual compression for attaining haemostasis after femoral sheath removal.

Impact of rural living on the experience of chronic illness.

This paper concentrates on the specific impact that living in rural Australia has on the experience of chronic illness, and draws on data collected in a larger phenomenological study. Eighteen rural Australians in New South Wales described their experiences and referred particularly to issues that related to their rural context. A secondary analysis of the data revealed three sub-themes related to the concept of rural, choice of doctor, travelling and life style. The shortfalls in service identified by these participants deserves further investigation and could become fertile ground for an expanded nursing service.

Intuition: an important tool in the practice of nursing.

AIM: The aim of the study reported here was to evaluate the role of intuition, to examine nurses' understanding of intuition and their perceptions of their use of intuition, and to assess the impact of intuition on nursing practice. BACKGROUND: When we read the dictionary definition of intuition, we have a sense of the meaning but there is also a sense of something still not quite defined. Yet we instinctively know what intuition is. That is, of course, an example of intuition in itself: an understanding of the concept based on our feelings, knowledge and experience. Intuition is a concept neither clearly articulated nor adequately theorized in nursing. There is evidence to suggest that practising nurses use intuition and that its use can change outcomes for patients. Because of its influence on patient well being, it needs to be recognized as an important tool in the practice of nursing. The very nature of intuition determines that there will be little agreement on a precise definition and little empirical evidence to support its existence or worth. Neither of these issues detracts from the fact that intuition is an important part of nursing. METHODS: Grounded theory was used as the overarching theoretical and methodological framework for this study. Using focus group interviews and the Delphi survey technique, data were collected from 262 Registered Nurses who volunteered to take part in the study. FINDINGS: The theory that emerged from this study provides nurses with a way of articulating their understanding of intuition and their perceptions of its use in nursing practice. CONCLUSIONS: Intuition is not some mystical power that appears from nowhere, with no rational explanation or basis. The findings from this study show that it is a product of the synergy that occurs as a result of the interaction of a number of factors.

The public health problem of acute respiratory illness in childcare.

Acute respiratory illness continues to be a significant problem for children attending childcare. The problems for the child are in terms of prevalence, incidence, and quality of life. Additional costs relate to parental absence from work and loss of earnings. This paper reports on the literature, and notes that little research has been undertaken to determine whether there are long-term risks or benefits to experiencing acute respiratory illness in early childhood. Research to date is presented, and the role of public health nurses is discussed in relation to how they might assist in reducing the incidence/prevalence of acute respiratory illness in children attending childcare.

Learning needs of Taiwanese nurses caring for patients with irritable bowel syndrome.

This study, building on work on irritable bowel syndrome conducted by Letson and Dancey (1996), explores Taiwanese nurses' knowledge, perceptions and beliefs about caring for patients with irritable bowel syndrome (IBS). A 46-item questionnaire was completed voluntarily by 120 registered nurses from a large tertiary acute care facility in Taiwan. The study used a descriptive research design and a questionnaire was developed that used a five-point Likert scale (strongly agree = 5, to strongly disagree = 1). The questionnaire consisted of six categories: demographic information; nurses' sources of IBS information; nurses' knowledge about IBS; nurses' perceptions about patients with IBS; nurses' beliefs about IBS; and learning requirements for nurses. Overall, the results indicted that Taiwanese nurses who participated in this study had little specific knowledge of IBS. The researchers developed a booklet containing information on the condition of IBS that may be used by the participants in this study to fill the knowledge gaps about this condition and provide useful information.

Acute respiratory illness in the first year of primary school related to previous attendance at child care.

The aim of this study was to assess the relationship between previous child care outside the home (day care or family care) and acute respiratory illness in the first year at primary school. Participants were 445 Adelaide school children (mean age 5 years 2 months), 73 per cent of those eligible. Information about early childhood, family, child care arrangements and illness history was obtained from a questionnaire completed by parents. A respiratory illness score was calculated from the parental reports of respiratory illness experience in the winter months of the second school term in 1992. Absences from school owing to respiratory illness were counted from school records. Children who had attended child care before commencing school had fewer episodes of acute respiratory illness and had fewer absences from school than children with no child care experience. Children who had attended child care prior to commencing school experienced half as many episodes of asthma as those children who had never attended child care. Children who attend day care before age five tend to experience less acute respiratory illness than their peers on school entry. Possible explanations include selection of illness-prone children into home care, protection against respiratory illness as a result of early exposure, and a shift in the age-related peak of illness.