Journal of clinical nursing
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Increasing variety in working patterns and the appearance of new forms of shift schedules in the different occupational sectors, including health services, have raised great concern about the quality of working life and job performance. The aim of this paper is to present a systematic review of the literature on the effects on health of irregular schedules in healthcare professionals. ⋯ No conclusive evidence was found to favour any particular work system, although there is evidence that extended workdays (9-12 h) should be avoided as much as possible. There is need for carefully designed studies in order to evaluate the long-term consequences of work schedules in healthcare workers.
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Low body temperature is induced by surface cooling to reduce metabolic demands in patients with severe cerebral injury. Shivering, which increases energy expenditure, is a common effect of surface cooling. The aim of this pilot study was to investigate whether increased gradient between the set point and peripheral temperature is related to shivering and whether modifying the loss of body heat during surface cooling decreases the frequency of shivering. ⋯ There was a significant association between increased temperature gradient and shivering (P < 0.01). Modifying the rate of heat loss decreased the temperature gradient (P < 0.001). By simultaneously measuring the tympanic and tip toe temperatures it may be possible to detect shivering earlier and decrease its frequency by modifying the loss of body heat during surface cooling.
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Comparative Study
A study of the effectiveness of different measuring times and counting methods of human radial pulse rates.
The purpose of this study was to determine the reliability and validity of measuring resting radial pulse rates by the use of three measuring times: 15, 30 and 60 s; and two counting methods: one beginning with zero (0) and the other with one (1). A two-factor within-subjects experimental design was used to determine the mean difference between pulse rates obtained from the radial artery, and the heart rates recorded by simultaneous electrocardiographic (ECG) recordings. The sample comprised 206 students. ⋯ For all measuring times, the mean difference between radial pulse rates and rates shown by the ECG were non-significant in the counting from one method. In other words, when the pulse rate is counted from one, the rates obtained at 15 or 30 s could be used to predict the one-minute resting pulse rates. The results of this study can contribute to the evidence base for this commonly used aspect of patient care.
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Our knowledge about the content of strategies used by staff members in a surgical recovery unit for assessment of post-operative pain is fairly limited. The aim of the present study was to describe variations in the content of strategies used by nurses and physicians in practical clinical pain assessments and to evaluate the clinical accuracy of the strategies used. Critical care nurses (n = 30), physicians (n = 30) and postsurgical patients (n = 180) comprise the respondents. ⋯ The recorded interviews were analysed to describe variations in ways of assessing pain. Pain assessment strategies were established by combining categories describing the impact of experience and categories of assessment criteria. The present observations, if included in the education of clinical staff members, could increase the understanding and thereby the quality of the pain assessment process.
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The aim of this study is to explore family members' perceptions of their immediate needs following admission of a relative to a critical care unit in Hong Kong. A convenience sample of 30 family members was drawn from those available during the first 96 hours of hospitalization of their relative. ⋯ Doctors and nurses are identified as the most suitable people to meet most immediate family needs. Conclusions are drawn as to the best focus of nursing interventions in order to provide quality care to patients and families.