Mary Jane Feldman

The relationship between knowledge about acquired immunodeficiency syndrome and the implementation of universal precautions by registered nurses.

The relationship between the level of knowledge of registered nurses [RNs] concerning acquired immunodeficiency syndrome [AIDS]-related issues and the practical observance of universal precautions was studied. It was hypothesized that the more knowledge a nurse has concerning AIDS the more likely he or she is to implement universal precautions. All registered nurses who have direct patient contact (N = 400) and are employed at a Northeastern teaching medical center, were provided a packet of three questionnaires and encouraged to participate. Two hundred thirteen (53%) RNs returned completed questionnaires Subgroups were examined for trends relating such parameters as age and the amount of AIDS knowledge, using analysis of variance. The major hypothesis was tested by correlating the scores for AIDS knowledge and the implementation score. Results indicated no relationship between knowledge and the implementation of universal precautions (r = −0.12). When evaluating scores according to work areas, those subjects with higher knowledge scores had lower practice scores. Other demographic variables showed no influence on either knowledge or implementation scores as measured by this study Further study is needed to understand what factors will motivate RNs to implement universal precautions.

Enhancing subject recruitment for nursing research.

NURSING RESEARCH MOST often requires human subjects. Consequently, an essential component in planning and conducting research entails recruitment of subjects who knowledgeably consent to participate. A well-established theoretical base exists regarding sampling techniques and procedures for research methods. The operationalization of the theory into practical terms may be of interest to the clinical nurse specialist (CNS) who frequently assumes a leadership role to both conduct nursing research in practice settings and to advise other nurses interested in conducting research. The recruitment efforts in four different nursing studies were compared and contrasted in an effort to determine effective and efficient approaches to this issue. Sample populations included nurse practitioners, patients, nurse aides, and nurse educators. Methods of recruitment included direct contact, mail, and telephone contact. While the settings, purposes, and designs of the studies varied, some common elements regarding subject recruitment were suggested. The recruitment methods have been described, along with the implication in terms of practical application for conduct of nursing research by CNSs.

Effectiveness of Health Promotion Interventions

The purpose of the study was to determine whether patients who participated in an intervention program would improve exercise and foot-care habits, reduce smoking, and would, in turn, have fewer PVD-related illnesses than patients not exposed to the intervention. Eighty-six patients with ankle/ brachial pressure indices of less than 1.0 on one or both legs were randomly assigned to a study (N=42) or control (N=44) group. All patients were assessed on a variety of health-related and activity behaviors prior to and again 26 weeks after enrollment in the study. Study patients who participated in the intervention worked with professionals on selecting programs designed to modify and improve their smoking, exercise, and/ or foot-care habits. At the end of 26 weeks, chi-square analysis showed no significant differences between study and control groups on change in smoking and foot care, although the results were in the anticipated direction. Study patients who chose to increase their exercise showed greater increase than control patients in frequency (p = .001), distance (p = .007), and length (p = .002) of walks. Although behaviors were modified, especially in the area of exercise, it was felt that longer interventions on a larger sample size are needed.

Cost Savings as an Indicator of Successful Nursing Intervention

The purpose of this study was to provide cost-related data from an intervention study in the care of patients with peripheral vascular disease (PVD). In a previously reported study, the study group patients increased exercise more than control patients, but there were no differences on any other health promoting behaviors or clinical outcomes. However, analysis of the differences between the study (N = 44) and the control patients (N = 42) on costs for health care during the course of the study demonstrated substantial differences. A fixed per diem rate was used to determine inpatient and outpatient costs. Study patients required significantly fewer PVD-related hospitalization and health care costs than control patients but not on vascular-related and nonvascular-related illnesses. Since there were no differences between the study and control on non-PVD illnesses, it appears that the intervention targeted to influence PVD problems did so. Limitations to the study are identified and additional research in this area is warranted.