Comparative analysis of two venipuncture learning methods on nursing students.

INTRODUCTION: Venus cannulation is one of the main nursing actions. For the safety of patients and nurses, this skill is important to be performed in a proper and responsible way. Thus, the need for adequate education on this skill is essential. STUDY OBJECTIVE: Comparison between the 4-stage (demonstration, deconstruction, comprehension, performance) learning method and the simplified 2-stage method (deconstruction, performance) on venous cannulation. METHODS: The study took place from November 2011 to March 2012. In total, 117 students of the Nursing Department of Technological Educational Institute of Athens were randomized into two education groups of the 2- (Group A) and 4- (Group B) stage method respectively. Students of both groups were assessed during training and 45days later for skill retention. For the assessment of all students, a check list with the steps required to venous cannulation was used. The time to complete the process was also assessed. RESULTS: Group A included 54 students and Group B 50 students. During initial training, the average time to complete the process without any errors was lower for Group A compared to Group B (1.77±0.12min vs. 2.33±0.13min, p=0.006). Regarding the appropriate steps for venous cannulation, Group A made fewer errors compared to Group B (0.95±0.95 vs. 1.38±1.10, p=0.021). In addition, Group A omitted more steps than Group B (0.29±0.06 vs. 0.11±0.05, p=0.042). During skill retention assessment, no significant difference was observed in the number of incorrect steps or in the number of omitted steps between groups. CONCLUSION: According to our findings, the 4-stage method, is associated with less omitted steps, while the 2-stage method, is associated with less time required to complete the procedure and less errors during performance, at initial stages. However, skill retention does not seem to be associated with the type of the educational methodology.

The meaning and importance of vigilant attendance for the relatives of intensive care unit patients.

AIM: To explore the meaning of vigilant attendance for relatives of critically ill patients in Greece. BACKGROUND: A plethora of international research has identified proximity to the patient to be a major concern for relatives of critically ill patients. Greece however follows a strict visiting policy in intensive care units (ICUs) so Greek relatives spend great amounts of time just outside the ICUs. DESIGN: This qualitative study adopted the social constructionist version of grounded theory. METHOD: Data were collected from three ICUs in Athens through in depth interviews with 25 informants and approximately 10 h of observations outside the ICUs on 159 relatives. FINDINGS: Vigilant attendance was one of the main coping mechanisms identified for relatives. Four subcategories were found to comprise vigilant attendance: (1) being as close as possible to feel relief, (2) being there to find out what is going on, (3) monitoring changes in the loved one and making own diagnosis and (4) interacting with the ICU professionals. CONCLUSION: Vigilant attendance describes the way in which relatives in Greece stayed outside the ICUs. Relatives felt satisfaction from being close as the best alternative for not actually being inside the ICU and they tried to learn what was going on by alternative methods. By seeing the patients, relatives were also able to make their own diagnoses and could therefore avoid relying solely on information given to them. However, a prerequisite for successful vigilant attendance was to get on well with doctors and nurses. RECOMMENDATIONS FOR CLINICAL PRACTICE: Changes in visiting policies in Greece are needed to meet the needs of relatives adequately. Recommendations for changes with minimal investment of time and funding are made.

The increase in illegal private duty nurses in public Greek hospitals.

AIM: To consider key aspects of the increasing substitution of legal private duty nurses by an illegal immigrant health-care workforce. BACKGROUND: Inadequate nursing care infrastructure and an oversupply of illegal immigrants, coupled with the current economic climate, favours the growth of an unofficial economy in hospital care. EVALUATION: Information gathered from literature, governmental and ministerial records, the media and the press are evaluated. KEY ISSUES: Increasing numbers of unauthorized immigrant health-care workers, facilitated by agencies, carry out undocumented private employment in hospitals for a considerably lower cost than their legal counterparts. Legal workers view their employment as being threatened and nurses have expressed concerns about quality of care and safety of patients, while at the same time health-care officials are unable to control this situation. CONCLUSIONS: It is anticipated that unless an appropriate care infrastructure is developed, this situation will persist and even escalate. The effects on patient care and the economy of the country, in general, need to be evaluated. IMPLICATIONS FOR NURSING MANAGEMENT: Managers ought to establish ways of improving the regulation and monitoring of illegal private duty nurses, in order to optimize the health, safety and wellbeing of patients.