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PubMedDate not supplied

Common errors made in resuscitation of respiratory and cardiac arrest.

The information contained in this article is based on the personal experience of the author and her colleagues. The author's experience includes: staff nurse in medical surgical and critical care nursing, midnight shift supervisor of six medical surgical nursing units in an urban teaching hospital (responsibilities included attending all codes in the department), staff nurse in a combined inpatient/outpatient postanesthesia care unit, nurse clinician/educator for multiple preoperation and postanesthesia care units, and attendance at numerous mortality and morbidity conferences held by the department of anesthesia. Research for this article included interviews with several colleagues with experience in medical surgical and critical care nursing as staff nurses, supervisors (responsible to attend codes), and staff educators. One colleague interviewed is also a regional faculty member of the American Heart Association and also a member of the CPR Committee of a large metropolitan teaching institution. The purpose of this article is to assist nurses in becoming more confident and comfortable in providing the interventions required by patients during resuscitation.

Anxiety↗
PubMed1986

Use of the Mega Code to evaluate team leader performance during advanced cardiac life support.

The Mega Code is a simulated cardiac arrest during which students practice as members of a team and learn to integrate the knowledge and skills of advanced cardiac life support (ACLS). This study used the Mega Code and American Heart Association (AHA) standards to evaluate 32 medical residents (MDs) and nine critical care nurses (RNs) in the role of ACLS team leader. All had been previously trained in ACLS. The testing sequence included ventricular fibrillation (VF) refractory to initial countershock (defib), asystole after second defib, recurrent VF after drug therapy, and finally sinus rhythm after third defib. A blood gas report indicated respiratory acidosis and hypoxemia. Assessment of patient status was poor in both groups, although MDs did significantly (p = .001) better than RNs. Other problem areas were drug therapy and trouble-shooting are not adequately stressed in the AHA ACLS curriculum; moreover, there is no lecture that specifically addresses the team approach to resuscitation and the role of team leader. We found that the Mega Code effectively evaluated individual and group performance. Results of objective-based Mega Code testing can be used both to improve ACLS curriculum and to indicate areas to be stressed during refresher training.

Cardiology↗
PubMed1995

Nurses take a stand on assisted suicide.

Nurses, individually and collectively, have an obligation to provide comprehensive and compassionate end-of-life care that includes the promotion of comfort and the relief of pain, and at times, foregoing life-sustaining treatments. The American Nurses Association (ANA) believes that the nurse should not participate in assisted suicide. Such an act is in violation of the Code for Nurses with Interpretive Statements (Code for Nurses) and the ethical traditions of the profession. There is a continuum of end-of-life choices that encompasses a broad spectrum of interventions from the alleviation of suffering, adequate pain control, do-not-resuscitate orders, withdrawing/withholding artificially provided nutrition and hydration, to requests for assisted suicide and active euthanasia. Throughout this continuum nurses can respond to patients with compassion, faithfulness and support. Yet, nurses must understand the subtleties and distinctions of these issues in order to respond in a reasoned and ethically permissible manner.

American Nurses' Association↗
PubMedDate not supplied

Representing nursing assessments in clinical information systems using the logical observation identifiers, names, and codes database.

In recent years, the Logical Observation Identifiers, Names, and Codes (LOINC) Database has been expanded to include assessment items of relevance to nursing and in 2002 met the criteria for "recognition" by the American Nurses Association. Assessment measures in LOINC include those related to vital signs, obstetric measurements, clinical assessment scales, assessments from standardized nursing terminologies, and research instruments. In order for LOINC to be of greater use in implementing information systems that support nursing practice, additional content is needed. Moreover, those implementing systems for nursing practice must be aware of the manner in which LOINC codes for assessments can be appropriately linked with other aspects of the nursing process such as diagnoses and interventions. Such linkages are necessary to document nursing contributions to healthcare outcomes within the context of a multidisciplinary care environment and to facilitate building of nursing knowledge from clinical practice. The purposes of this paper are to provide an overview of the LOINC database, to describe examples of assessments of relevance to nursing contained in LOINC, and to illustrate linkages of LOINC assessments with other nursing concepts.

Computational Biology↗
PubMed2005

Substance abuse among nurses--defining the issue.

The prevalence of substance abuse in the nurse population is believed to parallel that in the general population (i.e. approximately 10%). Nurses with substance abuse problems need help. They are in danger of harming patients, the facility's reputation, the nursing profession, and themselves. The consequences of not reporting concerns can be far worse than those of reporting the issue. Part one of this two-part series discusses how society views addiction and the nursing profession, signs and symptoms of substance abuse, reasons nurses should report an impaired colleague, the code of silence that exists among nurses, and board of nursing jurisdiction.

American Nurses' Association↗
PubMed1992

Teaching moral reasoning to student nurses.

Teaching moral reasoning to students is a challenge for all nursing educators. The National League for Nursing and American Nurses' Association emphasize the importance of ethical content within the curriculum. Review of the literature indicates that ethics has been part of the nursing curriculum since the early 1900s. However, the focus of nursing ethics has changed to more critical reflective thinking versus duties and etiquette. Educators have used a variety of methods for teaching ethics and integrating it into the curriculum. Yet nursing graduates still lack adequate skills to be morally accountable practitioners. This creates a dilemma for the educator to find ways to integrate more ethics content into an already crowded curriculum. The code of ethics of holistic nurses may serve as a basis to guide nurse educators in resolving some of the problems encountered in promoting moral education.

Codes of Ethics↗
PubMed1985

Lay obligations in professional relations.

Little has been written recently about the obligations of lay people in professional relationships. Yet the Code of Medical Ethics adopted by the American Medical Association in 1847 included an extensive statement on "Obligations of patients to their physicians'. After critically examining the philosophical foundations of this statement, I provide an alternative account of lay obligations in professional relationships. Based on a hypothetical social contract and included in a full specification of professional as well as lay obligations, this account requires lay people to honor commitments and disclose relevant information. Ethically, the account assumes that all parties in lay-professional relationships should be given equal consideration and respect in determining rights and obligations. Factually, it assumes that the treatment of many illnesses and injuries required collaboration and cooperation among lay persons and health professionals, that medical resources and personnel are limited, and that medicine, nursing, and related health professions, are, in MacIntyre's sense, practices.

American Medical Association↗
PubMed2000

Developing a database to describe the practice patterns of adult nurse practitioner students.

PURPOSE: To describe the practice patterns of adult nurse practitioner students using a database composed of core health data elements and standardized nursing language. DESIGN: Descriptive study of 3,733 patient visits documented by 19 adult nurse practitioner students in the academic year 1996-1997. METHODS: A database was designed for documenting the full scope of practice of adult nurse practitioner students by use of core health data elements and the standardized nursing languages of NANDA and NIC. Nurse practitioner students used the database to document every clinical encounter during their final clinical year of study. Most visits occurred in ambulatory care settings in a midwestern American city. FINDINGS: Based on the American Medical Association's Evaluation/Management coding system, data indicated that 50% of visits were classified as problem focused, while 31.9% were expanded, 10% were detailed, and 8.1% were comprehensive. The most frequently occurring NANDA diagnoses were pain, health-seeking behavior, altered health maintenance, and knowledge deficit. The most frequently reported nursing intervention classifications (NIC) were patient education, drug management, information management, and risk management. CONCLUSIONS: Using standardized nursing language to describe clinical encounters made visible the complex clinical decision-making patterns of adult nurse practitioner students. Systematic use of a database designed for documenting the full scope of practice of nurse practitioner students showed the applicability of standardized nursing language to advanced practice nursing contexts.

Adult↗