Texas nurses respond to mandatory continuing education.

This study investigated Texas nurses' attitudes toward mandatory continuing education, and their perceptions of skill improvement, knowledge enrichment, and improvement of health care to the public as a result of participation in continuing education programs. Seventy-two percent of the respondents had a positive attitude toward mandatory continuing education. Significant relationships were present between the attitudes and the perceptions of psychomotor skills improvement, cognitive improvement, affective skills improvement, and health care to the public. Four variables were predictive of the attitude toward mandatory education. In addition, the nurses preferred lecture or discussion formats and independent providers of continuing education.

Case manager role. A content analysis of published literature.

The case manager (CM) role is in its third decade of existence. However, there remains a lack of continuity in definition, educational level and qualifications, and the needed experience for role performance. This article presents the results of a content analysis of the published literature, conducted at two points in time, in an attempt to clarify common qualifications and skills needed for role implementation. The results suggest that the CM role requires interpersonal skills, and knowledge of planning, economic and evaluation strategies. Comparison of data for the two measurement times revealed an increased emphasis on the need to work in groups, conduct cost accounting, and facilitate change. Outcome measurement and ongoing evaluation experienced a decline in importance at the time of the second analysis. The ability to critically think, communicate and practice with clinical expertise emerge as inherent qualities of the role. Educational and experiential background remain ill defined in the literature.

Vulnerable populations in neuroscience nursing research.

Patients with neuroscience problems offer a wealth of data that can be collected as part of a research study. However, these patients are vulnerable to misunderstanding research purposes and procedures. They are also at risk for feeling pressured to participate in a study if they think it will make them recover or survive. In many instances, these neuroscience problems are devastating and even life-threatening. Because of the vulnerability of these patients, it is the responsibility of the neuroscience nurse to care for and also protect these patients. Therefore, it is incumbent upon nursing personnel to protect these vulnerable patients when they participate in nursing research studies.

Head trauma in the older adult population.

The elderly person who is brain injured requires some special considerations because of the effects of aging on the body and brain. These individuals are increasingly admitted to the intensive care units for trauma from accidents, falls, and so forth. In addition to the care for the problems associated with brain trauma, the nurse must also be aware of the patient's medical history to prevent complications related to drug interactions, fluid overload, or volume deficit. This article addresses these considerations.

Foundation for practice. Neuroassessment for neuroscience nurses.

Neuroassessment is the basis for clinical reasoning and nursing interventions in the neuroscience patient. This article discusses various types of assessment tools, and provides practical tips to help the nurse conduct a neurological exam and interpret the findings.

Off the beaten track: MSN education for a changing health care environment.

Given the dynamic nature of the health care environment, what should be the focus of graduate education in nursing? New advanced practice roles for nurses are emerging, but few university-based educational programs exist to respond to the need. In developing a Master's program, Baylor University School of Nursing accepted the challenge to deviate from tradition by preparing a nurse who has the advanced knowledge and skills necessary to proactively address the present and future needs of health care in multiple settings and roles. This article discusses this unique and creative program in patient care management. Outcome evaluation reveals that students are attaining the terminal objectives, meeting the outcome criteria, and readily securing employment.

Management of amyotrophic lateral sclerosis with riluzole.

In summary, riluzole is a recently-released drug for the treatment of ALS. While it will not cure the disease, it does prolong survival time and ventilator-free time. Riluzole has few adverse effects, but liver enzymes should be watched closely for elevations.

School-based management of chronic asthma among inner-city African-American schoolchildren in Dallas, Texas.

Asthma, a chronic disease of the respiratory tract, affects approximately five percent of the U.S. population, including almost five million children. Childhood asthma has been identified as the leading cause of school absences. This study was to examined efficacy of a school-based program to prevent exacerbation of asthma symptoms and manage asthma in school children using measured doses of an inhaled anti-inflammatory medication. The sample consisted of 22 African-American children in one inner-city elementary school in Dallas, Texas, ages 5-12 years with confirmed diagnoses of asthma. For three months, each child came to the school clinic two times per day for medication administration and measurement of respiratory peak flow rates. Data were collected for a number of variables including bronchodilator use, school absences, self-report of asthma symptoms, and number of visits to the physician. During the study, mean peak flow rates improved approximately 15%, and bronchodilator use decreased 66%. Improvement also was evident in several other areas.

Getting the right tool for the job.

In summary, getting the right tool for the job requires several steps prior to using the tool in an anticipated study. Finding obtaining and evaluating the tool are all critical to a successful use of the tool in the study. If any of these factors are not followed, the researcher could be ethically or legally in trouble. Most tool developers want their tools to be used. It is up to the researchers to ensure that credit is given where credit is due, and that due process is followed.

Body image in preoperative and postoperative lumbar laminectomy patients.

Many patients each year undergo a lumbar laminectomy for removal of a herniated disc. This study was conducted to determine if the patient had a change in body image from the preoperative to postoperative period. Body image was measured using the Body-Cathexis Scale. Twenty-four (24) patients were included in the study. Results indicated that there was a significantly higher difference in the total Body-Cathexis score postoperatively as compared to preoperatively. In addition, there was a significantly higher difference in the patients' ratings of back, knee, posture, energy level and sexual activity in the postoperative period. Further research is needed with a larger sample and over time to see whether these effects hold true.

Benign paroxysmal positional vertigo.

Benign paroxysmal positional vertigo (BPPV) is a peripheral vestibular disorder affecting the posterior semicircular canal. It is most often idiopathic in nature, though it has been known to occur in patients following head injury, Meniere's disease, acoustic neuroma and viral neuronitis. Two basic theories of the pathology of BPPV include cupulolithiasis and canalithiasis. Diagnosis is made by instituting the Hallpike-Dix maneuver to elicit the positional vertigo and nystagmus. While many patients suffer from BPPV on a limited basis, treatment options are available for those individuals with recurrent episodes and permanent BPPV, including surgery and conservative medical exercises and maneuvers. Nursing care is aimed toward teaching the exercises and maneuvers and assisting the patient to adjust the individual lifestyle movements that may precipitate an attack.

Neurologic assessment: you can make a difference in cost.

Neurological assessment is one way of decreasing patient hospital costs. By conducting thorough, systematic neurologic assessments both on admission and continuing throughout the hospital stay, the neuroscience nurse may be able to discover complications early so that treatment is not delayed. Thus, long-term problems could be avoided which might lead to further costs to the patient.

Creutzfeldt-Jakob disease.

While the incidence of Creutzfeldt-Jakob disease is very low worldwide, sufficient cases are appearing in neurological units to warrant increasing nursing information. In this article epidemiology, etiology, clinical manifestations, and diagnosis, specific nursing diagnoses and suggested areas of intervention with special reference to family involvement are addressed.

Glasgow Coma Scale scores in the patient post cardiopulmonary resuscitation.

This study was conducted to examine the difference in pre- and post-resuscitation Glasgow Coma Scale (GCS) scores in patients who suffered a cardiopulmonary arrest. Patients who arrested in an acute hospital setting were compared in terms of Glasgow Coma Scale scores with patients who arrested outside an acute hospital setting. The subjects for this study were 39 patients who arrested in the hospital and 16 patients who arrested outside the hospital setting. Data were collected over a period of one year using chart review. The data for this study included: GCS scores at one, two, four, twelve, and twenty-four hours post-arrest; age of the subjects; sex; site of arrest; and etiology of arrest. Results indicated that hospitalized arrest subjects had significantly higher GCS scores than out-of-hospital arrest subjects. Results further indicated that younger patients and those with myocardial infarctions had significantly higher GCS scores post-arrest. This study has implications for serial neurological assessment of the patient post-arrest.

Factors determining length of hospitalization for patients having laminectomy surgery.

The purpose of this study was to determine factors associated with length of stay for patients undergoing lumbar laminectomy. Significant differences were identified related to method of payment for hospitalization, number of doses of analgesic medications, and presence of muscle spasms. Other factors studied were sex, pre- or postoperative administration of steroids, presence of complications, age, length of surgical procedure and types of antispasmodic medications administered. The study was conducted in an urban north Texas hospital, using a retrospective review of 30 charts selected randomly. Further study of factors related to length of hospitalization is necessary in this, as well as other patient populations, especially since the advent of prospective payment.

Pineal region brain tumors.

Pineal region brain tumors occur in and around the pineal gland, a small cone-shaped structure in the posterior portion of the diencephalon. Pineal tumors can be divided into four basic categories: 1) germ cell tumors, 2) pineal tumors, 3) supporting cell tumors, and 4) cysts, or non-malignant conditions. Germinomas, one type of germ cell tumors, are the most common type of pineal region tumor. In overall incidence, pineal region tumors are relatively uncommon; however, because these tumors are mainly diagnosed in childhood and young adulthood, the incidence in that age group has been reported as high as nine percent. Pathophysiology and signs and symptoms are discussed as well as medical treatment and nursing care. The case study is a presentation of a 22-year-old male with a pineal region tumor.