Janet Secrest

Postoperative hypothermia—The chilling consequences

Unplanned hypothermia is commonly encountered in the perioperative period. Nursing has contributed to the literature on hypothermia with studies on shivering and treatment modalities; however, the direct physiological consequences of postoperative hypothermia have been reported mainly in the medical literature. Research on the physiological effects of postoperative hypothermia offers nurses further evidence to support interventions for temperature correction in patients with hypothermia. Evidence indicates that forced-air warming is the most effective method for warming hypothermic patients. The Roy Adaptation Model is explained as a framework for nursing care of patients with hypothermia. Clinical practice guidelines for unplanned perioperative hypothermia also are provided.

Stethoscopes as a Source of Hospital-Acquired Methicillin-Resistant Staphylococcus aureus

Stethoscopes are potential vectors of methicillin-resistant Staphylococcus aureus (MRSA). The purpose of this project was to determine the presence of MRSA on the diaphragms of personal and unit stethoscopes within a hospital setting before and after cleaning with alcohol prep pads. The sample consisted of 141 personal and unit stethoscopes in adult medical-surgical and intensive care units of a large university hospital in the Southeast. Each stethoscope was cultured once before cleaning and once after cleaning. Cultures were obtained using sterile swabs and inoculated on a selective medium for MRSA. Bacterial growth was noted in the precleaning group, but no MRSA colonies were detected. The postcleaning group had no bacterial growth. There was not enough data to statistically support that isopropyl alcohol is effective in decreasing bacterial counts; however, these findings suggest that current disinfection guidelines are effective in preventing MRSA colonization on stethoscopes in this setting.

Magnet therapy: what's the attraction?

Purpose To review the current state of the science of magnet therapy with respect to pain management and to view magnet therapy from a nursing perspective. Data Sources Extensive review of the world‐wide scientific literature and of scientific peer‐reviewed journals regarding magnet therapy. Conclusions Magnet therapy is gaining popularity; however, the scientific evidence to support the success of this therapy is lacking. More scientifically sound studies are needed in order to fully understand the effects that magnets can have on the body and the possible benefits or dangers that could result from their use. Implications for Practice Credibility for advanced practice will be established across disciplines as nurses demonstrate their ability to critically evaluate practices. Alternative therapies are accepted and used by many patients today. While magnet therapy is popular, the scientific evidence to support its use is limited, at best. Advanced practice nurses have more effective treatment modalities in their repertoire and are advised to avoid practices for which efficacy is unsupported.

The interaction model of client health behavior: A model for advanced practice nurses

PurposeTo present the Interaction Model of Client Health Behavior (IMCHB) as a model to guide nurse practitioners (NPs) in their practice. Data sourcesSelected research-based articles on Coxs IMCHB and selected text and writings on the NP movement and nursing practice models. ConclusionsMany NPs practice in a medical setting where the boundaries between medicine and nursing are blurred. The IMCHB offers a nursing model to guide NPs in their practice. Implications for practiceA nursing model that examines the elements of client uniqueness and assesses the interaction between NP and client can achieve positive health outcomes.

Utilization of foot care services among homeless adults: implications for advanced practice nurses.

Purpose: To present the findings of a survey that examined the reason(s) for use of foot care services among homeless adults in a mid‐size southeastern city. Data sources: Data were collected using an 18‐item questionnaire. One hundred homeless adults (65 males, 30 females) were asked about their level of foot care use, including under what circumstances foot care services might be used. Conclusion: Foot conditions are an important concern among homeless individuals. To add to the complexity of foot‐related problems, many respondents (N= 56) from this survey reported a history of diabetes, hypertension, and peripheral vascular disease. The majority (N= 92) of those surveyed value healthy feet and education related to foot care. Condition of shoes, socks, and foot odor was identified by participants (n= 62) as a major deterrent to using foot care services. Implication for practice: To increase use of foot care programs among homeless adults, services must be offered during the day time when they are not competing to secure nightly shelter. Foot care programs should be innovative and tailored to their unique needs and address concern for sensitivity to feet, sock, and shoe condition; cost; specific services provided; competing needs; source of care; and how to access these services.

A Community Needs Assessment for a SANE Program Using Neuman's Model

PURPOSE To present guidelines for a community needs assessment for a Sexual Assault Nurse Examiner (SANE) program using Neumans Systems Model. The guidelines provide advanced practice nurses with a holistic, systematic means to conduct an assessment prior to the implementation of a SANE program and facilitate collaborative work with other disciplines and agencies. DATA SOURCES Selected research‐based articles on sexual assault, classic texts and writings on Neumans Systems Model, and community assessment models and programs. CONCLUSIONS Sexual assault is a problem faced by almost every community. A thorough community assessment is an important first step in establishing programs that adequately meet a com‐munitys needs. Guidelines for conducting such an assessment related to implementation of a SANE program are rare, and guidelines using a nursing model were not found in the literature. IMPLICATIONS FOR PRACTICE One program that has been successful in meeting community needs is the SANE program. A concise and organized assessment guide can reduce the necessary time and money allocated for a community assessment and can provide a basis for evaluation and research.