Online journal of issues in nursing
-
Online J Issues Nurs · Jan 2003
Historical ArticleRace consciousness and the health of African Americans.
The historical experience of African Americans in our country has been shaped by the institution of slavery, dehumanization of blacks, segregation, pursuit of civil rights, and racism in contemporary American society. Disparities in health care provide compelling evidence that issues of race or skin color for the descendants of slaves and other ethnic minorities persist in the 21st century. Nurses providing care for African Americans must bridge the racial divide and incorporate culturally relevant content in the health history. As an integral aspect of their professional growth as culturally competent health care providers, they must incorporate the idea of "race consciousness" which is described as an awareness of the historical journey of the group, knowledge of disparities in health care for the people, and a self appraisal of one's attitudes and biases toward the group.
-
Approximately 1.3 million people in the United States will be diagnosed with cancer in 2003 and millions of other individuals are already living with the disease. Fatigue continues to be the most prevalent and disruptive symptom of cancer and its treatment regimens. ⋯ High levels of fatigue decrease quality of life, physical functional status, and symptom management. This article presents an evidenced-base review of cancer-related fatigue, strategies for the management of cancer-related fatigue, and recommendations for clinical practice.
-
Patient safety experts, including the Institute of Medicine Committee on Quality of Health Care in America, have emphasized the need to focus on systems failure as the source of most error in health care. This requires an emphasis on prevention and on health systems' accountability for error. This article discusses traditional and evolving approaches to systems' accountability for error. ⋯ These include identifying what systems will be held accountable for and how accountability will be enforced. While reporting of errors is one route toward accountability, many questions remain regarding the most effective approach toward error reporting. Research on and evaluation of reporting systems and other approaches toward systems' accountability will be important in moving forward in this area.
-
Online J Issues Nurs · Jan 2003
ReviewCare of patients with long-term indwelling urinary catheters.
The complications and management of long-term indwelling catheters used for urinary retention and incontinence were reviewed. Research evidence from 1992 - 2002 was located through searches of CINAHL (38 articles), and Medline (89 articles). Fifty studies were critiqued for this review. ⋯ Because of the complications of long-term indwelling catheter usage, periodic assessment and voiding trials should be used to determine the continued need for a catheter. Evidence-based recommendations for managing indwelling urinary catheters include screening for risk factors and evaluating urinary white blood cell count for infection, and assessment of the continued need for a catheter. Interventions include consideration of closed versus open drainage systems, type of catheter, and size of catheter lumen.