Using Microsoft Excel to teach statistics in a graduate advanced practice nursing program.

This article describes the authors' experiences during 3 years of using Microsoft Excel to teach graduate-level statistics, as part of the research core required by the American Association of Colleges of Nursing for all professional graduate nursing programs. The advantages to using this program instead of specialized statistical programs are ease of accessibility, increased transferability of skills, and reduced cost for students. The authors share their insight about realistic goals for teaching statistics to master's-level students and the resources that are available to faculty to help them to learn and use Excel in their courses. Several online sites that are excellent resources for both faculty and students are discussed. Detailed attention is given to an online course (Carnegie-Mellon University Open Learning Initiative, n.d.), which the authors have incorporated into their graduate-level research methods course.

Transparent film dressing vs pressure dressing after percutaneous transluminal coronary angiography.

BACKGROUND: Pressure dressings have been used as the standard following sheath removal after percutaneous transluminal angioplasty in many institutions. Patients complain about discomfort while the dressing is in place, pain when the dressing is removed after discharge, and skin complications afterward. Many patients have experienced skin irritation where tape has been applied. Nurses have also described difficulty assessing the sheath insertion site in the groin when a pressure dressing is in place. OBJECTIVES: To compare 3 different dressings with respect to effect on bleeding, discomfort voiced by patients, and ease of groin assessment in patients after percutaneous transluminal coronary angiography. METHODS: A total of 100 patients were randomly assigned to 1 of 3 groups: pressure dressing, transparent film dressing, or adhesive bandage. Outcome variables were bleeding, patient discomfort, and nurse-reported ease of observation of the groin site. RESULTS: No bleeding occurred in patients with transparent film dressings or adhesive bandages. Patients rated these dressings significantly higher than they rated the pressure dressing. Because two-thirds of the sample had previously undergone percutaneous transluminal coronary angiography, they could compare their experience with the new dressing with previous experiences with pressure dressings. Nurses rated the ease of assessing the groin significantly higher for the transparent film and adhesive bandage dressings than for pressure dressings. CONCLUSIONS: As a result of this study, a practice change was made hospital-wide: rather than a standard opaque pressure dressing, a transparent film dressing is used for all patients after removal of a femoral sheath.

Preoperative diabetes management protocol for adult outpatients.

The lack of evidence-based guidelines or nationally recognized protocols for the preoperative management of adult diabetics in the outpatient setting poses a challenge for the perianesthesia practitioner. The West Virginia University Hospital Perioperative Research Committee sought to develop an institutional protocol for management of this population. A retrospective chart review of diabetic outpatients who arrived the morning of surgery with elevated glucose levels was performed. The purpose of the chart review was to delineate indicators measured in the preoperative visit that could be predictive of patients arriving the morning of surgery with an elevated glucose level. Self-reported home fingerstick glucose values >200mg/dL were a statistically significant (p = .007) indicator of elevated arrival glucose in the preoperative holding area. Results of the chart review and best clinical evidence, as well as expert opinion, were used to develop an Adult Preoperative Diabetes Protocol and an accompanying Patient Instruction Tool.

Predictors of patient satisfaction with inpatient hospital nursing care.

The purpose of this predictive nonexperimental study was to investigate the influence of registered nurse (RN) job satisfaction, context of care, structure of care, patient-perceived nurse caring, and patient characteristics on patient satisfaction with inpatient hospital nursing care in an academic medical center in north-central West Virginia. Convenience samples of patients (N = 362) and RNs (N = 90) were recruited from two medical units, two surgical units, and three intensive care step-down units. Causal modeling identified patient-perceived nurse caring as the major predictor of patient satisfaction, with nurse/physician (RN/MD) collaboration as the only other direct predictor. Age had an indirect influence on patient satisfaction. Strategies to achieve and maintain patient satisfaction should address the enhancement of patient-perceived nurse caring and RN/MD collaboration.

The use of EMLA cream to decrease venipuncture pain in children.

Venipuncture is one of the most painful medical procedures for a child, and it is one of the most frequently performed. This literature synthesis reviews evidence for the use of eutectic mixture of local anesthetics (EMLA) cream to reduce the pain children experience during venipuncture. EMLA cream was compared with placebo, iontophoresis, and amethocaine cream and was found to be an effective local anesthetic for pediatric venipuncture pain during both intravenous cannulation and phlebotomy.

Predicting registered nurse job satisfaction and intent to leave.

BACKGROUND: Nurse job dissatisfaction has been the primary predictor of intent to leave; however, although many predictors of job satisfaction have been identified, little is known about the influence of variable nurse attitudes, such as psychological empowerment and hardiness, on job satisfaction. OBJECTIVE: The purpose of this study was to investigate the relative influence of nurse attitudes, context of care, and structure of care on job satisfaction and intent to leave. METHODS: A nonexperimental, predictive design evaluated these relationships in a nonrandom sample of 90 registered staff nurses using instruments with known psychometric properties. RESULTS: The major predictor of intent to leave was job dissatisfaction, and the major predictor of job satisfaction was psychological empowerment. Predictors of psychological empowerment were hardiness, transformational leadership style, nurse/physician collaboration, and group cohesion. CONCLUSIONS: Results supported the influence of nurse attitude on job satisfaction relative to other contributing factors.